Jeffrey Ray Stark, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6731 Issued in MO

Practice address

11638 W Florissant Ave
Florissant, MO 63033-6723

Phone

(314) 838-8780

Fax

(314) 838-8161

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Back & Neck Care Center of North County LLC

  • Chiropractor
  • Florissant, MO
  • NPI 1700260254
  Medicare reassignment NPD Authorized official
• Sevenhills Chiropractic Center PC

  • Chiropractor
  • Florissant, MO
  • NPI 1821196056
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598863748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11638 W FLORISSANT AVE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336723",
            "telephone_number": "314-838-8780",
            "fax_number": "314-838-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11638 W FLORISSANT AVE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336723",
            "telephone_number": "314-838-8780",
            "fax_number": "314-838-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "JEFFREY",
        "middle_name": "RAY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "6731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "399077",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "627934",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U.S. DEPT OF LABOR",
            "identifier": "20140300",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "126371",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Louis Medical Rehab Group LLC
• St. Sophia Healthcare, LLC
• Kaela Stahlhut, MT-BC
• Kathy Stanley
• Alex James Stark-Valdez, FNP
• Starrpointe Home Healthcare
• Ronnell Unae Stegall-Fleming
• Stephen E Kraft LLC
• Mary E Stephens
• Lakiska Stephenson-Perry

• Chiropractor in Florissant, MO
• Providers in Florissant, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.