Individual provider Active NPI

Justin Matthew Gregory, DC

  • Chiropractor
  • Branson, MO
National Provider Identifier
1194388959
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2019012253 Issued in MO
Practice address
225 Violyn Dr
Branson, MO 65616-8128
Phone
(417) 334-6660
Fax
(417) 334-6661
NPI assigned
Apr 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2019012253 MO Primary

Addresses

Primary practice location

225 Violyn Dr
Branson, MO 65616-8128

Mailing address

14 Wheatmill CT
Saint Charles, MO 63303-4301
Phone (636) 358-8607

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200414000610 MO Practitioner - Chiropractic 7618307752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healing Arts Center L.L.C.Group PAC ID 4789620261, 66 clinicians

Practice addresses (Care Compare)

225 Violyn Dr
Branson, MO 65616-8128
Phone 4173346660402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019012253MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hawk Ridge Family Chiropractic LLC Chiropractor CurrentSince Feb 27, 2020 Accepting new patients
Healing Arts Center L.L.C. Chiropractor CurrentSince Nov 7, 2022 Accepting new patients
Myocore, LLC Chiropractor PastSince Oct 10, 2021 Accepting new patients
Back on Track Eureka, LLC Chiropractor PastSince May 11, 2025 Accepting new patients

Locations

225 Violyn Dr
Branson, MO 65616
Phone (417) 334-6660

6257 Ronald Reagan Dr
Lake St Louis, MO 63367
Phone (636) 442-0607

6251 Ronald Reagan Dr
Lake St Louis, MO 63367
Phone (636) 614-2139

Organizations & group practices 4

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1194388959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WHEATMILL CT",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034301",
            "telephone_number": "636-358-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 VIOLYN DR",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656168128",
            "telephone_number": "417-334-6660",
            "fax_number": "417-334-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JUSTIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2019012253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.