Individual provider Active NPI

John Mischel, D.C.

  • Chiropractor
  • Fenton, MO
National Provider Identifier
1164801353
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2015015077 Issued in MO
Practice address
794 Gravois Bluffs Blvd Ste D
Fenton, MO 63026-7721
Phone
(314) 976-1125
NPI assigned
May 21, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2015015077 MO Primary
Chiropractor 111N00000X 038013281 IL

Addresses

Primary practice location

794 Gravois Bluffs Blvd Ste D
Fenton, MO 63026-7721

Mailing address

794 Gravois Bluffs Blvd Ste D
Fenton, MO 63026-7721
Phone (314) 967-1125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240516002875 MO Practitioner - Chiropractic 7810220860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

794 Gravois Bluffs Blvd
Suite D
Fenton, MO 63026-7721
Phone (314) 967-1125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038013281ILMDChiropractor
2015015077MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mischel Family Chiropractic LLC Chiropractor CurrentSince May 6, 2024 Accepting new patients

Locations

794 Gravois Bluffs Blvd
Ste D
Fenton, MO 63026
Phone (314) 967-1125

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": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1164801353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 GRAVOIS BLUFFS BLVD STE D",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267721",
            "telephone_number": "314-967-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 GRAVOIS BLUFFS BLVD STE D",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267721",
            "telephone_number": "314-976-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISCHEL",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2015015077",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.