Individual provider Active NPI

Matthew Thomas Huetter, CHIROPRACTOR

  • Chiropractor
  • Creve Coeur, MO
National Provider Identifier
1396515466
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2023050791 Issued in MO
Practice address
10510 Old Olive Street Rd
Creve Coeur, MO 63141-5926
Phone
(314) 718-7971
NPI assigned
Jan 8, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2023050791 MO Primary

Addresses

Primary practice location

10510 Old Olive Street Rd
Creve Coeur, MO 63141-5926

Mailing address

10510 Old Olive Street Rd
Creve Coeur, MO 63141-5926
Phone (314) 718-7971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241012000243 MO Practitioner - Chiropractic 7315479508 Reassigns benefits to 2 organizations
I20260324000141 IL Practitioner - Chiropractic 7315479508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropro of Highland, LLCGroup PAC ID 7012259625, 3 clinicians
Hawk Ridge Family Chiropractic LLCGroup PAC ID 5193910529, 4 clinicians

Practice addresses (Care Compare)

208 Flax Dr
Suite 200
Highland, IL 62249-1394
Phone (618) 651-6310

606 E Booneslick Rd
Warrenton, MO 63383-2102
Phone (636) 400-3213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023050791MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Huetter DC PC CurrentSince May 10, 2024 Accepting new patients
Cornerstone Chiropractic of Des Peres LLC Chiropractor CurrentSince May 21, 2025 Accepting new patients

Locations

10510 Old Olive Street Rd
Saint Louis, MO 63141
Phone (314) 718-7971

606 E Booneslick Rd
Warrenton, MO 63383
Phone (636) 400-3213

Organizations & group practices 4

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": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1396515466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 OLD OLIVE STREET RD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415926",
            "telephone_number": "314-718-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 OLD OLIVE STREET RD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415926",
            "telephone_number": "314-718-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUETTER",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "CHIROPRACTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2023050791",
            "primary": true
        }
    ],
    "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 Jan 8, 2024; 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.