NPIMap

Organization Active NPI

Tri Doctors Rehabilitation Group PC

Doing business as CompleteCare Medical

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1275690638
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
TRI DOCTORS REHABILITATION GROUP PC
Doing business as
CompleteCare Medical
Practice address
11911 Westline Industrial Dr
Saint Louis, MO 63146-3200
Phone
(636) 394-1200
Fax
(314) 569-1623
NPI assigned
Jan 3, 2007
Last updated
Jan 31, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
TRI DOCTOR REHABILITATION GROUP PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Authorized official

Name
Dr. Michael S Butler, D.C.,R NCS TNPI 1063599462
Title
Member
Phone
(636) 394-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X
Chiropractor 111N00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

11911 Westline Industrial Dr
Saint Louis, MO 63146-3200

Mailing address

11911 Westline Industrial Dr
Saint Louis, MO 63146-3200
Phone (636) 394-1200

Other identifiers 2

IdentifierTypeStateIssuer
107758OtherMOBLUE CROSS BLUE SHIELD
44 50059OtherMOUNITED HEALTH CARE

Other names 1

  • CompleteCare Medical Doing business as

National Provider Directory

National Provider Directory
Part of
Tri Doctors Rehabilitation Group PC

Locations

14792 Clayton Rd
Ballwin, MO 63011
Phone (636) 394-1200

11911 Westline Industrial Dr
Saint Louis, MO 63146
Phone (636) 394-1200

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391126400000",
    "number": "1275690638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11911 WESTLINE INDUSTRIAL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463200",
            "telephone_number": "636-394-1200",
            "fax_number": "314-569-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 WESTLINE INDUSTRIAL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463200",
            "telephone_number": "636-394-1200",
            "fax_number": "314-569-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI DOCTORS REHABILITATION GROUP PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRI DOCTOR REHABILITATION GROUP PC",
        "enumeration_date": "2007-01-03",
        "last_updated": "2014-01-31",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "636-394-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C.,R NCS T"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "107758",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "44 50059",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CompleteCare Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 31, 2014; 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.