Individual provider Active NPI

Felicity M. Keough, D.C.

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1295973535
Registry record updated Nov 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2009039678 Issued in MO
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

Updated by the provider on Nov 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
Ag Management Group LLCGroup PAC ID 2466638317, 3 clinicians

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. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
CH 9657FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ag Management Group LLC Chiropractor CurrentSince Jan 22, 2009 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.

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.

Verify at the official NPI Registry.