Organization Active NPI

Maryville Chiropractic, PC

  • Chiropractor
  • Maryville, MO
National Provider Identifier
1366634818
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006710 Issued in MO
Legal business name
MARYVILLE CHIROPRACTIC, PC
Practice address
1626 E 1St St
Maryville, MO 64468-3104
Phone
(660) 582-8511
Fax
(660) 582-8511
NPI assigned
Aug 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Dr. Douglas H Steiner, DCNPI 1730298639
Title
Ceo
Phone
(660) 582-8511

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 006710 MO Primary

Addresses

Primary practice location

1626 E 1St St
Maryville, MO 64468-3104

Mailing address

1626 E 1St St
Maryville, MO 64468-3104
Phone (660) 582-8511

Other identifiers 3

IdentifierTypeStateIssuer
82760OtherMOCOVENTRY
1730298639OtherMOCOMMUNITY HEALTH PLAN
670535OtherMOUNITED HEALTH CARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071023000506 MO Part B Supplier - Clinic/Group Practice 2163518093 Receives reassigned benefits from 1 practitioner
Practice locations: Maryville, MO

National Provider Directory

National Provider Directory

Locations

1626 E 1st St
Maryville, MO 64468
Phone (660) 582-8511

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1366634818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 E 1ST ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644683104",
            "telephone_number": "660-582-8511",
            "fax_number": "660-582-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 E 1ST ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644683104",
            "telephone_number": "660-582-8511",
            "fax_number": "660-582-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "STEINER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "660-582-8511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "82760",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH PLAN",
            "identifier": "1730298639",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "670535",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.