NPIMap

Individual provider Active NPI

Glen Bub, DC

  • Chiropractor
  • Chesterfield, MO
National Provider Identifier
1467498204
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
004853 Issued in MO
Practice address
1851 Schoettler Rd
Chesterfield, MO 63017-5529
Phone
(636) 227-2100
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 004853 MO Primary

Addresses

Primary practice location

1851 Schoettler Rd
Chesterfield, MO 63017-5529

Mailing address

1851 Schoettler Rd
Chesterfield, MO 63017-5529
Phone (636) 227-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brian M. Forbes, D. C. Chiropractor Past Accepting new patients
Chiropractic Pain Relief Centers, P.C Chiropractor PastSince Nov 1, 2003 Accepting new patients
Logan University Chiropractor PastSince Jun 1, 2005 Accepting new patients
Forbes Chiropractic & Rehab Chiropractor Past Accepting new patients
Gray Family Chiropractic PLLC Chiropractor Past Accepting new patients

Organizations & group practices 5

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467498204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 SCHOETTLER RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175529",
            "telephone_number": "636-227-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 SCHOETTLER RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175529",
            "telephone_number": "636-227-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUB",
        "first_name": "GLEN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "004853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.