Individual provider Active NPI

William Van Nessing, D.C.

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1407890148
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
004435 Issued in MO
Practice address
2621 Raymond Dr
Saint Charles, MO 63301-4872
Phone
(636) 946-2244
Fax
(636) 946-6975
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 004435 MO Primary
Independent Medical Examiner Chiropractor 111NI0013X 004435 MO

Addresses

Primary practice location

2621 Raymond Dr
Saint Charles, MO 63301-4872

Mailing address

629 St Francois
Florissant, MO 63031-4919
Phone (314) 839-4646

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120113000520 MO Practitioner - Chiropractic 6305013384 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004435MOMDIndependent Medical Examiner Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Depression Clinic at the Health Centers Current Accepting new patients

Locations

2621 Raymond Dr
Saint Charles, MO 63301
Phone (636) 946-2244

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1407890148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 ST FRANCOIS",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630314919",
            "telephone_number": "314-839-4646",
            "fax_number": "314-839-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 RAYMOND DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633014872",
            "telephone_number": "636-946-2244",
            "fax_number": "636-946-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESSING",
        "first_name": "WILLIAM",
        "middle_name": "VAN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "004435",
            "primary": true
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "MO",
            "license": "004435",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.