Justin Pantleo

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2015030812 Issued in MO

Practice address

611 W Mount Vernon St Ste C
Nixa, MO 65714-9601

Phone

(417) 724-2225

Fax

(417) 724-2268

NPI assigned

Aug 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life Chiropractic Clinic LLC

  • Chiropractor
  • Nixa, MO
  • NPI 1629445564
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1376910216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W MOUNT VERNON ST STE C",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149601",
            "telephone_number": "417-724-2225",
            "fax_number": "417-724-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W MOUNT VERNON ST STE C",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149601",
            "telephone_number": "417-724-2225",
            "fax_number": "417-724-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTLEO",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2015030812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nixa Residential, LLC
• Nixas Main Street Chiropractic LLC
• Northland Hearing Centers, Inc.
• Landon Michael O'Steen
• Optimal Health, LLC
• Amanda Y Patton, M.S.CCC-SLP
• Rachal Payne, RN
• Tina Bates Pennington, L.P.C.
• Jeremiah L. Penrod, SMFT
• Pharmacy Consultants Plus Inc.

• Chiropractor in Nixa, MO
• Providers in Nixa, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.