Organization Active NPI

Chiropro of St Charles Mo, LLC

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1306426812
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIROPRO OF ST CHARLES MO, LLC
Practice address
3711 Mexico Rd
Saint Charles, MO 63303-3040
Phone
(618) 979-0398
Fax
(618) 234-8295
NPI assigned
Apr 9, 2021
Last updated
Apr 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Authorized official

Name
Robert Rice, DCNPI 1174620975
Title
Owner/President
Phone
(618) 979-0398

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

3711 Mexico Rd
Saint Charles, MO 63303-3040

Mailing address

3711 Mexico Rd
Saint Charles, MO 63303-3040
Phone (618) 979-0398

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210618001556 MO Part B Supplier - Clinic/Group Practice 9335549922 Receives reassigned benefits from 4 practitioners
Practice locations: Saint Charles, MO

National Provider Directory

National Provider Directory

Locations

3711 Mexico Rd
Saint Charles, MO 63303
Phone (314) 660-3591

3711 Mexico Rd
Ste B
Saint Charles, MO 63303
Phone (636) 410-5858

Practitioners & affiliated clinicians

Practitioners 11

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": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1306426812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 MEXICO RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033040",
            "telephone_number": "618-979-0398",
            "fax_number": "618-234-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 MEXICO RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033040",
            "telephone_number": "618-979-0398",
            "fax_number": "618-234-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRO OF ST CHARLES MO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "618-979-0398",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.