Active NPI
Back & Neck Care Center of Webster Groves, LLC
- Chiropractor
- Webster Groves, MO
National Provider Identifier
1609043298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CE004876
- Legal business name
- BACK & NECK CARE CENTER OF WEBSTER GROVES, LLC
- Practice address
- 604 E Lockwood Ave
Webster Groves, MO 63119-3219 - Phone
- (314) 968-4696
- Fax
- (314) 968-0484
- NPI assigned
- May 13, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Joseph T. Lane, D.C.
- Title
- Owner
- Phone
- (314) 968-4696
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CE004876 | MO | Primary |
Addresses
Primary practice location
604 E Lockwood Ave
Webster Groves, MO 63119-3219
Mailing address
604 E Lockwood Ave
Webster Groves, MO 63119-3219
Phone (314) 968-4696
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9360 | Other | MO | BLUE CROSS BLUE SHIELD |
| 2027274 | Other | MO | AETNA |
| 625709 | Other | MO | ACN |
| 4401192 | Other | MO | UNITED HEALTH CARE |
| 114153 | Other | MO | HEATLTH LINK |
National Provider Directory
National Provider DirectoryLocations
604 E Lockwood Ave
Webster Grvs, MO 63119
Phone (314) 968-4696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320364800000",
"number": "1609043298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 E LOCKWOOD AVE",
"city": "WEBSTER GROVES",
"state": "MO",
"postal_code": "631193219",
"telephone_number": "314-968-4696",
"fax_number": "314-968-0484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 E LOCKWOOD AVE",
"city": "WEBSTER GROVES",
"state": "MO",
"postal_code": "631193219",
"telephone_number": "314-968-4696",
"fax_number": "314-968-0484"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BACK & NECK CARE CENTER OF WEBSTER GROVES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-13",
"last_updated": "2011-11-04",
"status": "A",
"authorized_official_last_name": "LANE",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "T.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "314-968-4696",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "MO",
"license": "CE004876",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "9360",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2027274",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN",
"identifier": "625709",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "4401192",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEATLTH LINK",
"identifier": "114153",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Webster Groves, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.