NPIMap

Organization Active NPI

Dr. Matthew Nicholson LLC

  • Chiropractor
  • O'Fallon, MO
National Provider Identifier
1609172311
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2010001122 Issued in MO
Legal business name
DR. MATTHEW NICHOLSON LLC
Practice address
2520 Highway K
O Fallon, MO 63368-6625
Phone
(636) 978-5511
NPI assigned
Jan 28, 2011
Last updated
Jul 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Authorized official

Name
Dr. Matthew Nicholson, DCNPI 1720319817
Title
Owner
Phone
(636) 978-5511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2010001122 MO Primary

Addresses

Primary practice location

2520 Highway K
O Fallon, MO 63368-6625

Mailing address

2520 Highway K
O Fallon, MO 63368-6625
Phone (636) 978-5511

National Provider Directory

National Provider Directory

Locations

2520 Highway K
O Fallon, MO 63368
Phone (636) 978-5511

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1609172311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686625",
            "telephone_number": "636-978-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686625",
            "telephone_number": "636-978-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MATTHEW NICHOLSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-978-5511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2010001122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.