Individual provider Active NPI

Abraham Michael Carpenter, D.C.

  • Chiropractor
  • O'Fallon, MO
National Provider Identifier
1457678393
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2010013340 Issued in MO
Practice address
2315 Highway K
O Fallon, MO 63368-8659
Phone
(636) 978-6995
NPI assigned
May 3, 2010
Last updated
Mar 16, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2010013340 MO Primary

Addresses

Primary practice location

2315 Highway K
O Fallon, MO 63368-8659

Mailing address

15462 Elk Ridge LN
Chesterfield, MO 63017-5350
Phone (314) 359-5038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817001659 MO Practitioner - Chiropractic 7113051756 Practice locations: Ofallon, MO

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2315 Hwy K
Georgia Chiropractic
Ofallon, MO 63366-8659
Phone (636) 978-6998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Friedrichs Physical Therapy, LLC PastSince Nov 1, 2014 Accepting new patients
Georgia Chiropractic LLC Chiropractor PastSince Oct 1, 1999 Accepting new patients

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, 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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1457678393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15462 ELK RIDGE LN",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175350",
            "telephone_number": "314-359-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688659",
            "telephone_number": "636-978-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "ABRAHAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-03",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2010013340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.