Individual provider Active NPI

Katherine Reckelhoff, D.C.

  • Chiropractor
  • Wildwood, MO
National Provider Identifier
1508004011
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2009000024 Issued in MO
Practice address
16921 Manchester Rd
Suite B
Wildwood, MO 63040-1209
Phone
(636) 352-9718
NPI assigned
Jan 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2009000024 MO Primary

Addresses

Primary practice location

16921 Manchester Rd
Suite B
Wildwood, MO 63040-1209

Mailing address

16921 Manchester Rd
Suite B
Wildwood, MO 63040-1209
Phone (636) 352-9718

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2009000024MOMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1508004011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16921 MANCHESTER RD",
            "address_2": "SUITE B",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401209",
            "telephone_number": "636-352-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16921 MANCHESTER RD",
            "address_2": "SUITE B",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401209",
            "telephone_number": "636-352-9718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECKELHOFF",
        "first_name": "KATHERINE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2009000024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.