Individual provider Active NPI

Abigail Newsom, D.C.

  • Chiropractor
  • Saint Peters, MO
National Provider Identifier
1275959629
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2014002112 Issued in MO
Practice address
107 Olympic Way
Saint Peters, MO 63376-1664
Phone
(636) 244-5223
Fax
(636) 244-5224
NPI assigned
Mar 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2014002112 MO Primary

Addresses

Primary practice location

107 Olympic Way
Saint Peters, MO 63376-1664

Mailing address

107 Olympic Way
Saint Peters, MO 63376-1664
Phone (636) 244-5223

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
2014002112MOMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1275959629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 OLYMPIC WAY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761664",
            "telephone_number": "636-244-5223",
            "fax_number": "636-244-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 OLYMPIC WAY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761664",
            "telephone_number": "636-244-5223",
            "fax_number": "636-244-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSOM",
        "first_name": "ABIGAIL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2014002112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jul 22, 2019; 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.