Individual provider Active NPI

Elizabeth Louise Blair, D.C.

  • Orthopedic Chiropractor
  • Kansas City, MO
National Provider Identifier
1629139688
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
2005000397 Issued in MO
Practice address
3611 Main St
Suite 103
Kansas City, MO 64111-1932
Phone
(816) 561-7035
Fax
(816) 960-3890
NPI assigned
Dec 13, 2006
Last updated
Aug 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 2005000397 MO Primary

Addresses

Primary practice location

3611 Main St
Suite 103
Kansas City, MO 64111-1932

Mailing address

3611 Main St
Suite 103
Kansas City, MO 64111-1932
Phone (816) 561-7035

Other identifiers 5

IdentifierTypeStateIssuer
694678OtherMOACN
36591032OtherMOBLUE CROSS BLUE SHIELD
1196322OtherMOAETNA HMO
277729OtherMOCOVENTRY
7854791OtherMOAETNA PPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005000397MOMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Wellness Center PC PastSince Mar 9, 2006 Accepting new patients
FMH Health Solutions PC PastSince Jul 17, 2012 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1629139688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 MAIN ST",
            "address_2": "SUITE 103",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641111932",
            "telephone_number": "816-561-7035",
            "fax_number": "816-960-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 MAIN ST",
            "address_2": "SUITE 103",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641111932",
            "telephone_number": "816-561-7035",
            "fax_number": "816-960-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "ELIZABETH",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "MO",
            "license": "2005000397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "694678",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36591032",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1196322",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "277729",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7854791",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.

Verify at the official NPI Registry.