Tina Marie Poulson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2024040714 Issued in MO

Practice address

302 SE Independence Ave
Lees Summit, MO 64063-2828

Phone

(816) 867-0992

NPI assigned

Oct 7, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Evergreen Chiropractic LLC

  • Chiropractor
  • Lees Summit, MO
  • NPI 1306665054
  NPD

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1215756234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E REMINGTON TER",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640838537",
            "telephone_number": "816-724-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 SE INDEPENDENCE AVE",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632828",
            "telephone_number": "816-867-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSON",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2024040714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Marie Pomeroy, MS
• Porter Chiropractic and Acupuncture, LLC
• Brianna R Porter, D.C.
• Russell Porter, D.C.
• Madeleine Grace Posz
• Alan E Powell, MD
• Martin Matthew Powers, D.C.
• Prairie Township Fire Protection District
• Prairie Township Fire Protection District of Jackson Co
• Carol Anna Pranulis, OD

• Chiropractor in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.