Individual provider Active NPI

Terrence K McKellar, D.C.

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1447393137
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
004887 Issued in MO
Practice address
1000 Fairgrounds Rd
Suite 101
Saint Charles, MO 63301-2381
Phone
(636) 947-4046
Fax
(636) 947-6787
NPI assigned
Feb 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 004887 MO Primary

Addresses

Primary practice location

1000 Fairgrounds Rd
Suite 101
Saint Charles, MO 63301-2381

Mailing address

1000 Fairgrounds Rd
Suite 101
Saint Charles, MO 63301-2381
Phone (636) 947-4046

Other identifiers 5

IdentifierTypeStateIssuer
122805OtherMOHEALTHLINK
4397546OtherMOAETNA
10144OtherMOMISSOURI BLUE CROSS BLUE
16626OtherMOGROUP HEALTH PLAN
4450049OtherMOUNITED HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110120000063 MO Practitioner - Chiropractic 0749469930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Indian Hills CT
Saint Charles, MO 63301-0715
Phone (636) 947-4046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004887MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Able Chiropractic Arts, PC CurrentSince Jan 20, 2011 Accepting new patients

Locations

1000 Fairgrounds Rd
Ste 101
Saint Charles, MO 63301
Phone (636) 947-4046

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447393137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 FAIRGROUNDS RD",
            "address_2": "SUITE 101",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012381",
            "telephone_number": "636-947-4046",
            "fax_number": "636-947-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 FAIRGROUNDS RD",
            "address_2": "SUITE 101",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012381",
            "telephone_number": "636-947-4046",
            "fax_number": "636-947-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELLAR",
        "first_name": "TERRENCE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "004887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "122805",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4397546",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI BLUE CROSS BLUE",
            "identifier": "10144",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "16626",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4450049",
            "state": "MO"
        }
    ],
    "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 Jul 8, 2007; 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.