Organization Active NPI

Baker Chiropractic & Rehab, LLC

  • Chiropractor
  • Maryville, MO
National Provider Identifier
1568617686
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2008015698 Issued in MO
Legal business name
BAKER CHIROPRACTIC & REHAB, LLC
Practice address
2408 S Main St Ste a
Maryville, MO 64468-3624
Phone
(660) 582-4357
Fax
(866) 239-7931
NPI assigned
Nov 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Authorized official

Name
Dr. Matthew Ray Baker, D.C.NPI 1346398088
Title
Chiropractor/Member
Phone
(660) 582-4357

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 2008015698 MO Primary

Addresses

Primary practice location

2408 S Main St Ste a
Maryville, MO 64468-3624

Mailing address

2408 S Main St Ste a
Maryville, MO 64468-3624
Phone (660) 582-4357

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090113000194 MO Part B Supplier - Clinic/Group Practice 8921161639 Receives reassigned benefits from 1 practitioner
Practice locations: Maryville, MO

National Provider Directory

National Provider Directory

Locations

1010 S Main St
Maryville, MO 64468
Phone (660) 582-4357

2408 S Main St
#A
Maryville, MO 64468
Phone (660) 582-4357

Practitioners & affiliated clinicians

Practitioners 3

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": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1568617686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 S MAIN ST STE A",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644683624",
            "telephone_number": "660-582-4357",
            "fax_number": "866-236-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 S MAIN ST STE A",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644683624",
            "telephone_number": "660-582-4357",
            "fax_number": "866-239-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAKER CHIROPRACTIC & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "CHIROPRACTOR/MEMBER",
        "authorized_official_telephone_number": "660-582-4357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2008015698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.