Life Chiropractic Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2015030812 Issued in MO

Legal business name

LIFE CHIROPRACTIC CLINIC LLC

Practice address

611 W Mount Vernon St Ste C
Nixa, MO 65714-9601

Phone

(417) 724-2225

NPI assigned

Aug 26, 2015

Last updated

Sep 24, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Pantleo, D.C.NPI 1376910216

Title

Owner

Phone

(417) 724-2225

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 3

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.

• Justin Pantleo

  • Chiropractor
  • Nixa, MO
  • NPI 1376910216
  Medicare reassignment NPD Authorized official
• Kimberly A. Benton, DC

  • Chiropractor
  • Neosho, MO
  • NPI 1144460023
  NPD (past)
• Kandy Lynn Hanafin Vice, DC

  • Chiropractor
  • Springfield, MO
  • NPI 1588651863
  NPD (past)

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1629445564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W MOUNT VERNON ST STE C",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W MOUNT VERNON ST STE C",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149601",
            "telephone_number": "417-724-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "PANTLEO",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-724-2225",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2015030812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lester E Cox Medical Centers (CoxHealth Nixa Clinic)
• Lester E Cox Medical Centers (CoxHealth Urgent Care Nixa)
• Holly K Letterman-Hitt, FNP-BC
• Grace Susan Levering
• Cece Lewis
• Life Enhancement Village
• Life Enhancement Village of the Ozarks, Inc.
• Life Enhancement Village Operating Company LLC
• Life Expressions Chiropractic
• Life Solutions, LLC

• Chiropractor in Nixa, MO
• Providers in Nixa, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.