Organization Active NPI

Eden Chiropractic and Wellness Center

  • Chiropractor
  • Saint Peters, MO
National Provider Identifier
1487785630
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2007007487 Issued in MO
Legal business name
EDEN CHIROPRACTIC AND WELLNESS CENTER
Practice address
4231 N Saint Peters Pkwy
Saint Peters, MO 63304-7384
Phone
(636) 928-0311
Fax
(636) 928-8670
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Authorized official

Name
Dr. Fatiha Kalimah McCaine, D.C.NPI 1841344249
Title
Owner
Phone
(314) 330-3904

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2007007487 MO Primary

Addresses

Primary practice location

4231 N Saint Peters Pkwy
Saint Peters, MO 63304-7384

Mailing address

4231 N Saint Peters Pkwy
Saint Peters, MO 63304-7384
Phone (636) 928-0311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070425000179 MO Part B Supplier - Clinic/Group Practice 4587769237 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Peters, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1487785630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 N SAINT PETERS PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633047384",
            "telephone_number": "636-928-0311",
            "fax_number": "636-928-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4231 N SAINT PETERS PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633047384",
            "telephone_number": "636-928-0311",
            "fax_number": "636-928-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN CHIROPRACTIC AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "MCCAINE",
        "authorized_official_first_name": "FATIHA",
        "authorized_official_middle_name": "KALIMAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-330-3904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007007487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.