Individual provider Active NPI

Daniel O. Reiter, D.C.

  • Chiropractor
  • Bonne Terre, MO
National Provider Identifier
1518962869
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
004488 Issued in MO
Practice address
21 W School St
Bonne Terre, MO 63628-1509
Phone
(573) 358-3356
Fax
(573) 358-7652
NPI assigned
Jun 14, 2005
Last updated
Sep 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 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 004488 MO Primary

Addresses

Primary practice location

21 W School St
Bonne Terre, MO 63628-1509

Mailing address

PO Box 436
Bonne Terre, MO 63628-0436
Phone (573) 358-3356

Other identifiers 1

IdentifierTypeStateIssuer
753261106MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100907000851 MO Practitioner - Chiropractic 1355435645 Practice locations: Saint Louis, MO; Bonne Terre, MO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004488MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Hill Chiropractic PC Chiropractor Past Accepting new patients
Daniel Oliver Reiter Chiropractor PastSince Mar 13, 2001 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1518962869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 436",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636280436",
            "telephone_number": "573-358-3356",
            "fax_number": "573-358-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W SCHOOL ST",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636281509",
            "telephone_number": "573-358-3356",
            "fax_number": "573-358-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITER",
        "first_name": "DANIEL",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "004488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "753261106",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonne Terre, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.