NPIMap

Organization Active NPI

Roots of Wellness Chiropractic LLC

  • Chiropractor
  • Chesterfield, MO
National Provider Identifier
1629393087
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2009030088 Issued in MO
Legal business name
ROOTS OF WELLNESS CHIROPRACTIC LLC
Practice address
510 Baxter Rd
Suite 8
Chesterfield, MO 63017-7032
Phone
(636) 227-4442
Fax
(636) 227-4449
NPI assigned
Mar 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Authorized official

Name
Dr. Daniel Fazio, D.C.
Title
Owner
Phone
(636) 227-4442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2009030088 MO Primary

Addresses

Primary practice location

510 Baxter Rd
Suite 8
Chesterfield, MO 63017-7032

Mailing address

510 Baxter Rd
Suite 8
Chesterfield, MO 63017-7032
Phone (636) 227-4442

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1629393087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 BAXTER RD",
            "address_2": "SUITE 8",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177032",
            "telephone_number": "636-227-4442",
            "fax_number": "636-227-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BAXTER RD",
            "address_2": "SUITE 8",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177032",
            "telephone_number": "636-227-4442",
            "fax_number": "636-227-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS OF WELLNESS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "FAZIO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-227-4442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2009030088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.