Excelsior Chiropractic Center, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

005147 Issued in MO

Legal business name

EXCELSIOR CHIROPRACTIC CENTER, PC

Practice address

1000 N Jesse James Rd Ste 3
Excelsior Springs, MO 64024-1244

Phone

(816) 620-6211

Fax

(816) 630-6211

NPI assigned

Aug 31, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Ina M Berry, OM

Title

Office Manager

Phone

(816) 620-6211

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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

• Randolph Roy Decker, D.C.

  • Chiropractor
  • Excelsior Springs, MO
  • NPI 1548253156
  Medicare reassignment NPD

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1194919282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N JESSE JAMES RD STE 3",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241244",
            "telephone_number": "816-620-6211",
            "fax_number": "816-630-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N JESSE JAMES RD STE 3",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241244",
            "telephone_number": "816-620-6211",
            "fax_number": "816-630-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR CHIROPRACTIC CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "INA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-620-6211",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OM"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "005147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "12330037",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4412828",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2032917",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "4400182",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "T73784",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "T78406",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KS",
            "identifier": "532434",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDC",
            "identifier": "P00058846",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kiefner Earle, DDS
• Pamela Easley
• Aubrie Edwards, FNP-BC
• Allison Kathleen Eggert, PT, DPT
• Karen S Evans
• Excelsior Spring 1 Inc
• Excelsior Springs City Hospital
• Excelsior Springs City Hospital
• Excelsior Springs City Hospital
• Excelsior Springs City Hospital

• Chiropractor in Excelsior Springs, MO
• Providers in Excelsior Springs, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.