Active NPI
Felicity M. Keough, D.C.
- Chiropractor
- Saint Charles, MO
National Provider Identifier
1295973535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2009039678
- Practice address
- 2440 Executive Dr Ste 100
Saint Charles, MO 63303-5607 - Phone
- (636) 244-4994
- Fax
- (636) 244-3134
- NPI assigned
- Jan 24, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH 9657 | FL | |
| Chiropractor | 111N00000X | 2009039678 | MO | Primary |
Addresses
Primary practice location
2440 Executive Dr Ste 100
Saint Charles, MO 63303-5607
Mailing address
2440 Executive Dr Ste 100
Saint Charles, MO 63303-5607
Phone (636) 244-4994
Other names 1
- Dr. Felicity Mae Keough-Bligh
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110511000223 | MO | Practitioner - Chiropractic | 1456537307 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2008
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
2440 Executive Dr
Suite 100
Saint Charles, MO 63303-5607
Phone (636) 244-4994
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH 9657 | FL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ag Management Group LLC | Chiropractor | Current | Accepting new patients |
Locations
2440 Executive Dr
Ste 100
Saint Charles, MO 63303
Phone (636) 244-4994
20 Triad South Dr
Saint Charles, MO 63304
Phone (636) 244-4994
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.
-
- Chiropractor
- Saint Charles, MO
- NPI 1477872901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636761600000",
"number": "1295973535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2440 EXECUTIVE DR STE 100",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633035607",
"telephone_number": "636-244-4994",
"fax_number": "636-244-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 EXECUTIVE DR STE 100",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633035607",
"telephone_number": "636-244-4994",
"fax_number": "636-244-3134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOUGH",
"first_name": "FELICITY",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-24",
"last_updated": "2021-11-13",
"certification_date": "2021-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH 9657",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2009039678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "FELICITY",
"last_name": "KEOUGH-BLIGH",
"middle_name": "MAE",
"prefix": "DR.",
"credential": "DC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.