Stephanie Smith, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2004004400 Issued in MO

Practice address

16925 Manchester Rd
Suite 1
Grover, MO 63040-1219

Phone

(636) 458-7575

Fax

(636) 458-7979

NPI assigned

Jul 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Optimal Health Chiropractic LLC

  • Chiropractor
  • Grover, MO
  • NPI 1073732863
  NPD (past) Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619996394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 CARMEL WOODS DR",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630214715",
            "telephone_number": "636-527-1876",
            "fax_number": "636-458-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16925 MANCHESTER RD",
            "address_2": "SUITE 1",
            "city": "GROVER",
            "state": "MO",
            "postal_code": "630401219",
            "telephone_number": "636-458-7575",
            "fax_number": "636-458-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2004004400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marla M Olish, PNP
• Optimal Health Chiropractic LLC
• Elizabeth Pemberton, AGNP
• Karl Robert Peterson, APRN CNM
• Professional Healthcare Services, LLC
• Andrew Warner, M.ED, PLPC
• Judy M Wylie, LPC

• Chiropractor in Grover, MO
• Providers in Grover, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.