Individual provider Active NPI

Hannah Claire Fredrickson, DC

  • Chiropractor
  • Saint Peters, MO
National Provider Identifier
1235843376
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2022048904 Issued in MO
Practice address
1232 Jungermann Rd
Saint Peters, MO 63376-6963
Phone
(636) 685-0717
Fax
(636) 685-0721
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2022048904 MO Primary

Addresses

Primary practice location

1232 Jungermann Rd
Saint Peters, MO 63376-6963

Mailing address

1232 Jungermann Rd
Saint Peters, MO 63376-6963
Phone (636) 685-0717

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stpeters@thewellnessway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022048904MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Heartstone Missouri LLC Chiropractor CurrentSince Aug 28, 2024 Accepting new patients

Locations

1232 Jungermann Rd
Saint Peters, MO 63376
Phone (314) 730-5434

Organizations & group practices 1

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": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1235843376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 JUNGERMANN RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766963",
            "telephone_number": "636-685-0717",
            "fax_number": "636-685-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 JUNGERMANN RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766963",
            "telephone_number": "636-685-0717",
            "fax_number": "636-685-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "HANNAH",
        "middle_name": "CLAIRE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2022048904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stpeters@thewellnessway.com",
            "affiliation": "N",
            "endpointDescription": "stpeters@thewellnessway.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct",
            "address_1": "1232 Jungermann Rd",
            "city": "Saint Peters",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633766963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 25, 2023; 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.