Individual provider Active NPI

Linda Christine Pecaut, D.C.

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1154597177
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2007015254 Issued in MO
Practice address
3123 Hampton Ave
Saint Louis, MO 63139-2303
Phone
(314) 605-2725
NPI assigned
Apr 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2007015254 MO Primary

Addresses

Primary practice location

3123 Hampton Ave
Saint Louis, MO 63139-2303

Mailing address

3123 Hampton Ave
Saint Louis, MO 63139-2303
Phone (314) 647-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081211000675 MO Practitioner - Chiropractic 1052472834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007015254MOMDChiropractor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1154597177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 HAMPTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631392303",
            "telephone_number": "314-647-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3123 HAMPTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631392303",
            "telephone_number": "314-605-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECAUT",
        "first_name": "LINDA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007015254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.