Individual provider Active NPI

Alexander Heitman, D.C.

  • Chiropractor
  • Rolla, MO
National Provider Identifier
1376081356
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2017003593 Issued in MO
Practice address
806A E State Route 72
Rolla, MO 65401-3945
Phone
(573) 368-2702
NPI assigned
Feb 9, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2017003593 MO Primary

Addresses

Primary practice location

806A E State Route 72
Rolla, MO 65401-3945

Mailing address

806A E State Route 72
Rolla, MO 65401-3945
Phone (573) 368-2702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170310000314 MO Practitioner - Chiropractic 4183908197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic and Spinal Rehab LLCGroup PAC ID 4688958044, 2 clinicians

Practice addresses (Care Compare)

806A E State Route 72
Rolla, MO 65401-3945
Phone (573) 364-2798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017003593MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic and Spinal Rehab LLC Chiropractor CurrentSince Mar 1, 2017 Accepting new patients
Chiropractic and Spinal Rehab, LLC Past Accepting new patients

Locations

806A E State Route 72
Rolla, MO 65401
Phone (573) 364-2798

Organizations & group practices 2

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": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1376081356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806A E STATE ROUTE 72",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013945",
            "telephone_number": "573-368-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806A E STATE ROUTE 72",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013945",
            "telephone_number": "573-368-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITMAN",
        "first_name": "ALEXANDER",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017003593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.