NPIMap

Organization Active NPI

Crestwood Back and Neck Pain Clinic

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1194169334
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CRESTWOOD BACK AND NECK PAIN CLINIC
Practice address
9109 Watson Rd
Saint Louis, MO 63126-2235
Phone
(314) 961-4101
NPI assigned
Apr 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Authorized official

Name
Nick Calandro
Title
Owner
Phone
(314) 961-4101

Specialties & licenses 1

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

Addresses

Primary practice location

9109 Watson Rd
Saint Louis, MO 63126-2235

Mailing address

9109 Watson Rd
Saint Louis, MO 63126-2235
Phone (314) 961-4101

National Provider Directory

National Provider Directory

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": "1366243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366243200000",
    "number": "1194169334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9109 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631262235",
            "telephone_number": "314-961-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631262235",
            "telephone_number": "314-961-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD BACK AND NECK PAIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-04-18",
        "status": "A",
        "authorized_official_last_name": "CALANDRO",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-961-4101"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "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 Apr 18, 2013; 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.