Organization Active NPI

Sports & Family Chiropractic & Acupuncture

  • Chiropractor
  • Chesterfield, MO
National Provider Identifier
1194018408
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2007000313 Issued in MO
Legal business name
SPORTS & FAMILY CHIROPRACTIC & ACUPUNCTURE
Practice address
132 Chesterfield Commons Rd E
Chesterfield, MO 63005-1440
Phone
(636) 530-1212
NPI assigned
May 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Authorized official

Name
Dr. Joshua A Kilpatrick, DCNPI 1386799682
Title
Owner/ President
Phone
(636) 530-1212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2007000313 MO Primary

Addresses

Primary practice location

132 Chesterfield Commons Rd E
Chesterfield, MO 63005-1440

Mailing address

10510 Old Olive Street Rd
Creve Coeur, MO 63141-5926
Phone (314) 991-2295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110622000494 MO Part B Supplier - Clinic/Group Practice 7517145543 Receives reassigned benefits from 1 practitioner
Practice locations: Chesterfield, MO

National Provider Directory

National Provider Directory

Locations

132 Chesterfield Commons Rd E
Chesterfield, MO 63005
Phone (636) 530-1212

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1194018408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 OLD OLIVE STREET RD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415926",
            "telephone_number": "314-991-2295",
            "fax_number": "314-991-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 CHESTERFIELD COMMONS RD E",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051440",
            "telephone_number": "636-530-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS & FAMILY CHIROPRACTIC & ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-18",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "KILPATRICK",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "636-530-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007000313",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 1, 2020; 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.