NPIMap

Organization Active NPI

Family Wellness Chiropractic

  • Chiropractor
  • Chesterfield, MO
National Provider Identifier
1558749853
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2005014052 Issued in MO
Legal business name
FAMILY WELLNESS CHIROPRACTIC
Practice address
2109 Woodlet Park Dr
Chesterfield, MO 63017-5034
Phone
(314) 607-2231
NPI assigned
May 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Authorized official

Name
Dr. Carrie Ann Jardine, DC
Title
Owner
Phone
(314) 607-1038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2005014052 MO Primary

Addresses

Primary practice location

2109 Woodlet Park Dr
Chesterfield, MO 63017-5034

Mailing address

2109 Woodlet Park Dr
Chesterfield, MO 63017-5034
Phone (314) 607-1038

Other identifiers 1

IdentifierTypeStateIssuer
1649471988OtherMOINDIVIDUAL NPI

National Provider Directory

National Provider Directory
Tax ID family
Family Wellness Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430956800000",
    "number": "1558749853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 WOODLET PARK DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175034",
            "telephone_number": "314-607-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 WOODLET PARK DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175034",
            "telephone_number": "314-607-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY WELLNESS CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2015-05-07",
        "status": "A",
        "authorized_official_last_name": "JARDINE",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-607-1038",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2005014052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1649471988",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; 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.