Individual provider Active NPI

Dan Mecklenburg

  • Durable Medical Equipment & Medical Supplies
  • Chesterfield, MO
National Provider Identifier
1376768796
Registry record updated Apr 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Practice address
2144 Courtleigh LN
Suite 100
Chesterfield, MO 63017-7623
Phone
(314) 871-9306
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2144 Courtleigh LN
Suite 100
Chesterfield, MO 63017-7623

Mailing address

PO Box 4202
Chesterfield, MO 63006-4202
Phone (314) 871-9306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Biomedical Durable Medical Equipment & Medical Supplies Past Accepting new patients

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239321600000",
    "number": "1376768796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4202",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630064202",
            "telephone_number": "314-871-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2144 COURTLEIGH LN",
            "address_2": "SUITE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177623",
            "telephone_number": "314-871-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECKLENBURG",
        "first_name": "DAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2009-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.