Organization Active NPI

Koelling & Turnbull Chiropractic Center, P.C.

  • Sports Physician Chiropractor
  • Saint Peters, MO
National Provider Identifier
1215112040
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
005857 Issued in MO
Legal business name
KOELLING & TURNBULL CHIROPRACTIC CENTER, P.C.
Practice address
1345 Queens CT
Suite B
Saint Peters, MO 63376-7356
Phone
(636) 477-6100
Fax
(636) 477-7287
NPI assigned
Dec 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Authorized official

Name
Dr. Richard A Koelling, D.C.NPI 1740363076
Title
President
Phone
(636) 477-6100

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NS0005X 005857 MO Primary
Sports Physician ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NS0005X 006014 MO

Addresses

Primary practice location

1345 Queens CT
Suite B
Saint Peters, MO 63376-7356

Mailing address

1345 Queens CT
Suite B
Saint Peters, MO 63376-7356
Phone (636) 477-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041210000073 MO Part B Supplier - Clinic/Group Practice 0547227662 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Peters, MO

National Provider Directory

National Provider Directory

Locations

1345 Queens Ct
#B
Saint Peters, MO 63376
Phone (636) 477-6100

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": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1215112040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 QUEENS CT",
            "address_2": "SUITE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767356",
            "telephone_number": "636-477-6100",
            "fax_number": "636-477-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 QUEENS CT",
            "address_2": "SUITE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767356",
            "telephone_number": "636-477-6100",
            "fax_number": "636-477-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOELLING & TURNBULL CHIROPRACTIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "KOELLING",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-477-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "MO",
            "license": "005857",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "MO",
            "license": "006014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.