Individual provider Active NPI

Kristine Marie Pickens

  • Chiropractor
  • Eureka, MO
National Provider Identifier
1487494324
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2023050500 Issued in MO
Practice address
113 W 5TH St
Eureka, MO 63025-1109
Phone
(636) 938-9310
Fax
(636) 938-3204
NPI assigned
May 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2023050500 MO Primary

Addresses

Primary practice location

113 W 5TH St
Eureka, MO 63025-1109

Mailing address

113 W 5TH St
Eureka, MO 63025-1109
Phone (636) 938-9310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240727000384 MO Practitioner - Chiropractic 1951847847 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023050500MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Chiropractic PC Chiropractor CurrentSince Jul 1, 2024 Accepting new patients

Locations

113 W 5th St
Eureka, MO 63025
Phone (636) 938-3210

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1487494324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W 5TH ST",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251109",
            "telephone_number": "636-938-9310",
            "fax_number": "636-938-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W 5TH ST",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251109",
            "telephone_number": "636-938-9310",
            "fax_number": "636-938-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKENS",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2023050500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.