Individual provider Active NPI

Brett Ashley Winchester, D.C.

  • Chiropractor
  • Troy, MO
National Provider Identifier
1255473864
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2003011597 Issued in MO
Practice address
34 Professional Pkwy
Troy, MO 63379-2822
Phone
(366) 356-5557
Fax
(636) 775-2659
NPI assigned
Feb 12, 2007
Last updated
Dec 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2003011597 MO Primary

Addresses

Primary practice location

34 Professional Pkwy
Troy, MO 63379-2822

Mailing address

34 Professional Pkwy
Troy, MO 63379-2822
Phone (636) 356-5557

Other practice location 1

40 Walter Ct
Moscow Mills, MO 63362-1197
Phone (636) 356-5557

Other identifiers 4

IdentifierTypeStateIssuer
551715OtherMOHEALTHLINK
7368716OtherMOAETNA
653134OtherMOUNITED HEALTH CARE
471354OtherMOBLUE CROSS BLUE SHIELD MO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@winspineandsport.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031222000528 MO Practitioner - Chiropractic 4284531294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Winchester Chiropractic, P.C.Group PAC ID 9638147432, 5 clinicians

Practice addresses (Care Compare)

34 Professional Pkwy
Troy, MO 63379-2822
Phone (636) 356-5557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2003011597MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Chiropractic, P.C. Chiropractor CurrentSince Jul 1, 2003 Accepting new patients
Erin McQueen DC, LLC Chiropractor Past Accepting new patients

Locations

40 Walter Ct
Moscow Mills, MO 63362
Phone (636) 356-5557

34 Professional Pkwy
Troy, MO 63379
Phone (636) 356-5557

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1255473864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PROFESSIONAL PKWY",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792822",
            "telephone_number": "636-356-5557",
            "fax_number": "636-775-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PROFESSIONAL PKWY",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792822",
            "telephone_number": "366-356-5557",
            "fax_number": "636-775-2659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Walter Ct",
            "address_purpose": "LOCATION",
            "city": "Moscow Mills",
            "state": "MO",
            "postal_code": "633621197",
            "country_code": "US",
            "telephone_number": "636-356-5557",
            "fax_number": "636-356-5558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINCHESTER",
        "first_name": "BRETT",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2003011597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "551715",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7368716",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "653134",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MO",
            "identifier": "471354",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@winspineandsport.com",
            "affiliation": "N",
            "address_1": "34 Professional Pkwy",
            "city": "Troy",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633792822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.