Individual provider Active NPI

Marlee Gunn-Coleman

  • Chiropractor
  • Chesterfield, MO
National Provider Identifier
1154888139
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2022049108 Issued in MO
Practice address
17684 Chesterfield Airport Rd
Chesterfield, MO 63005-1214
Phone
(363) 454-8266
NPI assigned
Feb 26, 2019
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2022049108 MO Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

17684 Chesterfield Airport Rd
Chesterfield, MO 63005-1214

Mailing address

155 Elvree St
Manchester, CT 06042-8242

Other identifiers 1

IdentifierTypeStateIssuer
987599836OtherUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2022049108MOMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1154888139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 ELVREE ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060428242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17684 CHESTERFIELD AIRPORT RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051214",
            "telephone_number": "363-454-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNN-COLEMAN",
        "first_name": "MARLEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2022049108",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "987599836",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.