Active NPI
Nofa Jane Shibley, DC
- Chiropractor
- St. Louis, MO
National Provider Identifier
1477563823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MO006581
- Practice address
- 625 N Euclid
#225
St. Louis, MO 63108 - Phone
- (314) 361-4325
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | MO006581 | MO | Primary |
Addresses
Primary practice location
625 N Euclid
#225
St. Louis, MO 63108
Mailing address
PO Box 4175
Chesterfield, MO 63006
Phone (314) 361-4325
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BCBS 111678 | Other | MO | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120116000029 | MO | Practitioner - Chiropractic | 1052588076 | Practice locations: Saint Louis, MO |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 1997
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4660 Maryland Ave
Suite 200
Saint Louis, MO 63108-1929
Phone (314) 791-2411
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO006581 | MO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281484800000",
"number": "1477563823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4175",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "63006",
"telephone_number": "314-361-4325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 N EUCLID",
"address_2": "#225",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63108",
"telephone_number": "314-361-4325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIBLEY",
"first_name": "NOFA",
"middle_name": "JANE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2010-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "MO006581",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "BCBS 111678",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in St. Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.