Individual provider Active NPI

Ronald Glennon Nisbet Jr., D.C.

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1265521082
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2006032027 Issued in MO
Practice address
7539 Ravensridge Rd
Saint Louis, MO 63119-5502
Phone
(314) 973-8936
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2006032027 MO Primary

Addresses

Primary practice location

7539 Ravensridge Rd
Saint Louis, MO 63119-5502

Mailing address

657 Showplace CT
Ballwin, MO 63021-6252
Phone (314) 973-8936

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265521082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 SHOWPLACE CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630216252",
            "telephone_number": "314-973-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7539 RAVENSRIDGE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195502",
            "telephone_number": "314-973-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISBET",
        "first_name": "RONALD",
        "middle_name": "GLENNON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2006032027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.