Individual provider Active NPI

L. Shane Hart, D.C.

  • Chiropractor
  • Bowling Green, MO
National Provider Identifier
1407960123
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005241 Issued in MO
Practice address
300 W Main St
Bowling Green, MO 63334-1561
Phone
(573) 324-2225
Fax
(573) 324-6250
NPI assigned
Aug 18, 2006
Last updated
Mar 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 005241 MO Primary

Addresses

Primary practice location

300 W Main St
Bowling Green, MO 63334-1561

Mailing address

300 W Main St
P.O. Box 308
Bowling Green, MO 63334-1561
Phone (573) 324-2225

Other identifiers 8

IdentifierTypeStateIssuer
22424OtherMOBLUE CHOICE
5227583OtherMOAETNA
752706705MedicaidMO
22424OtherMOBLUE CROSS BLUE SHIELD
39-1886617OtherMOTRIAD
910850-633OtherMOFIRST HEALTH
T43528OtherMOMERCY HEALTH PLANS
44-50040OtherMOUNITED HEALTH CARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012000882 MO Practitioner - Chiropractic 7012109804 Practice locations: Bowling Green, MO

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 W Main St
Bowling Green, MO 63334-1561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005241MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hart Care Chiropractic Center Chiropractor PastSince Dec 31, 1991 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1407960123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST",
            "address_2": "P.O. BOX 308",
            "city": "BOWLING GREEN",
            "state": "MO",
            "postal_code": "633341561",
            "telephone_number": "573-324-2225",
            "fax_number": "573-324-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST",
            "city": "BOWLING GREEN",
            "state": "MO",
            "postal_code": "633341561",
            "telephone_number": "573-324-2225",
            "fax_number": "573-324-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "L.",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "005241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "22424",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5227583",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "752706705",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "22424",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIAD",
            "identifier": "39-1886617",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "910850-633",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLANS",
            "identifier": "T43528",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "44-50040",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.