Bradley A Davis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CE006537 Issued in MO

Practice address

5650 Mexico Rd
Ste 20
Saint Peters, MO 63376-1696

Phone

(636) 936-1100

Fax

(636) 936-1655

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dettenmeier Chiropractic LLC

  • Chiropractor
  • Saint Peters, MO
  • NPI 1407569197
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154427300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 HARRINGTON PL",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767706",
            "telephone_number": "636-294-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5650 MEXICO RD",
            "address_2": "STE 20",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761696",
            "telephone_number": "636-936-1100",
            "fax_number": "636-936-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRADLEY",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE006537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Davey, OTRL
• David a. Lipsitz, PH.D., Inc
• David Guilbeault DMD Mid Rivers Dental Group
• David M Ivey DDS PC
• Sasha Marie David
• Christine Denise Davis, M.S.
• Jennifer Lueders Davis, FNP-C
• Kendall Lamont Davis Jr.
• Lauren M Davis, AU.D.
• Omar M Dawood, MD

• Chiropractor in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.