Organization Active NPI

Delta Spinal Rehab P.C.

  • Chiropractor
  • Creve Coeur, MO
National Provider Identifier
1366697195
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2001032183 Issued in MO
Legal business name
DELTA SPINAL REHAB P.C.
Practice address
11720 Old Ballas Rd Ste 2
Creve Coeur, MO 63141-7028
Phone
(314) 725-3358
NPI assigned
Nov 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. Christopher John Maffit, D.C.NPI 1891785499
Title
Owner
Phone
(314) 725-3358

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 2001032183 MO Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 2001021787 MO

Addresses

Primary practice location

11720 Old Ballas Rd Ste 2
Creve Coeur, MO 63141-7028

Mailing address

11720 Old Ballas Rd Ste 2
Creve Coeur, MO 63141-7028
Phone (314) 725-3358

Other practice location 1

8403 Maryland Ave
Clayton, MO 63105-3646
Phone (314) 725-3358

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090116000232 MO Part B Supplier - Clinic/Group Practice 1153484183 Receives reassigned benefits from 1 practitioner
Practice locations: Creve Coeur, MO

National Provider Directory

National Provider Directory

Locations

8403 Maryland Ave
Clayton, MO 63105
Phone (314) 725-3358

11720 Old Ballas Rd
Ste 2
Saint Louis, MO 63141
Phone (314) 725-3358

Practitioners & affiliated clinicians

Practitioners 3

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": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1366697195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11720 OLD BALLAS RD STE 2",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417028",
            "telephone_number": "314-725-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11720 OLD BALLAS RD STE 2",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417028",
            "telephone_number": "314-725-3358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8403 Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "MO",
            "postal_code": "631053646",
            "country_code": "US",
            "telephone_number": "314-725-3358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DELTA SPINAL REHAB P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MAFFIT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-725-3358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2001032183",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2001021787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.