Organization Active NPI

Franklin County Chiropractic PC

  • Chiropractor
  • Union, MO
National Provider Identifier
1619134608
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2003011572 Issued in MO
Legal business name
FRANKLIN COUNTY CHIROPRACTIC PC
Practice address
100 Union Plaza Dr
Union, MO 63084-3145
Phone
(636) 583-1380
Fax
(636) 583-1588
NPI assigned
May 19, 2008
Last updated
Apr 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Dr. Kimberly Ann Jacquin, DCNPI 1710049101
Title
President
Phone
(636) 583-1380

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
Chiropractor 111N00000X 2003011572 MO Primary

Addresses

Primary practice location

100 Union Plaza Dr
Union, MO 63084-3145

Mailing address

PO Box 148
Union, MO 63084-0148
Phone (636) 583-1380

Other identifiers 2

IdentifierTypeStateIssuer
DB6771OtherMORAILROAD MEDICARE GROUP PIN
175676OtherMOBLUE CROSS GROUP PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051208000645 MO Part B Supplier - Clinic/Group Practice 2860413614 Receives reassigned benefits from 1 practitioner
Practice locations: Union, MO

National Provider Directory

National Provider Directory

Locations

100 Union Plaza Dr
Union, MO 63084
Phone (636) 207-9500

118 Union Plaza Dr
Union, MO 63084
Phone (636) 583-1380

Practitioners & affiliated clinicians

Practitioners 2

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": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1619134608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 148",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630840148",
            "telephone_number": "636-583-1380",
            "fax_number": "636-583-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 UNION PLAZA DR",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630843145",
            "telephone_number": "636-583-1380",
            "fax_number": "636-583-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN COUNTY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "JACQUIN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-583-1380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2003011572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PIN",
            "identifier": "DB6771",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP PIN",
            "identifier": "175676",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.