NPIMap

Organization Active NPI

Logan University

  • Chiropractor
  • Chesterfield, MO
National Provider Identifier
1194765941
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LOGAN UNIVERSITY
Practice address
1851 Schoettler Rd.
Chesterfield, MO 63017
Phone
(636) 227-2100
Fax
(636) 207-2447
NPI assigned
Jun 8, 2006
Last updated
May 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Authorized official

Name
Alissa J Dawson, BUSINESS DIRECTOR
Title
Business Director
Phone
(636) 230-1808

Specialties & licenses 1

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

Addresses

Primary practice location

1851 Schoettler Rd.
Chesterfield, MO 63017

Mailing address

1851 Schoettler Rd.
Chesterfield, MO 63017
Phone (636) 227-2100

Other names 1

  • Logan College of Chiropractic Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220000119 MO Part B Supplier - Clinic/Group Practice 5698660322 Receives reassigned benefits from 18 practitioners
Practice locations: Chesterfield, MO; Saint Louis, MO; Saint Peters, MO

National Provider Directory

National Provider Directory

Locations

2067 Zumbehl Rd
Saint Charles, MO 63303
Phone (314) 947-4770

12494 Tesson Ferry Rd
Saint Louis, MO 63128
Phone (314) 849-3800

1281 S Laclede Station Rd
Saint Louis, MO 63119
Phone (314) 961-1948

7888 Mexico Rd
Saint Peters, MO 63376
Phone (636) 397-3545

8071 Watson Rd
Webster Grvs, MO 63119
Phone (314) 961-2450

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1194765941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 SCHOETTLER RD.",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "636-227-2100",
            "fax_number": "636-207-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 SCHOETTLER RD.",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "636-227-2100",
            "fax_number": "636-207-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "ALISSA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "636-230-1808",
        "authorized_official_credential": "BUSINESS DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan College of Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 May 14, 2015; 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.