Active NPI
Tamra A Nobbe, D.C.
- Chiropractor
- O Fallon, MO
National Provider Identifier
1174633481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CE05026
- Practice address
- 110 E Pitman St
O Fallon, MO 63366-2619 - Phone
- (636) 272-4625
- Fax
- (636) 240-3522
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CE05026 | MO | Primary |
Addresses
Primary practice location
110 E Pitman St
O Fallon, MO 63366-2619
Mailing address
110 E Pitman St
O Fallon, MO 63366-2619
Phone (636) 272-4625
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44-00212 | Other | MO | UHC |
| 110526 | Other | MO | HEALTHLINK |
| 4456568 | Other | MO | AETNA |
| 11152 | Other | MO | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101122000319 | MO | Practitioner - Chiropractic | 1254527815 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CE05026 | MO | MD | Chiropractor |
| 005026 | MO | MD | Mechanotherapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ofallon Chiropractic & Acupuncture LLC | Chiropractor | Current | Accepting new patients |
Locations
110 E Pitman St
O Fallon, MO 63366
Phone (636) 272-4625
110 E Pitman St
#187
O Fallon, MO 63366
Phone (636) 272-4625
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.
-
- Chiropractor
- O Fallon, MO
- NPI 1821108143
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236038400000",
"number": "1174633481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 E PITMAN ST",
"city": "O FALLON",
"state": "MO",
"postal_code": "633662619",
"telephone_number": "636-272-4625",
"fax_number": "636-240-3522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E PITMAN ST",
"city": "O FALLON",
"state": "MO",
"postal_code": "633662619",
"telephone_number": "636-272-4625",
"fax_number": "636-240-3522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOBBE",
"first_name": "TAMRA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2009-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "CE05026",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "44-00212",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "110526",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4456568",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "11152",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.