Organization Active NPI

Metro Chiropractic Centre, Inc.

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1639218324
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5913 Issued in MO
Legal business name
METRO CHIROPRACTIC CENTRE, INC.
Practice address
2108 Schuetz Rd
Saint Louis, MO 63146-3538
Phone
(314) 567-7300
Fax
(314) 997-4326
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Authorized official

Name
Dr. Robert Eugene Elder, D.C.NPI 1487723425
Title
President
Phone
(314) 567-7300

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5913 MO Primary

Addresses

Primary practice location

2108 Schuetz Rd
Saint Louis, MO 63146-3538

Mailing address

2108 Schuetz Rd
Saint Louis, MO 63146-3538
Phone (314) 567-7300

Other identifiers 3

IdentifierTypeStateIssuer
15344OtherMOBLUE CROSS BLUE SHIELD
4413038OtherMOAETNA
791611OtherMOHEALTHLINK GROUP PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000033 MO Part B Supplier - Clinic/Group Practice 7618068925 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1639218324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 SCHUETZ RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463538",
            "telephone_number": "314-567-7300",
            "fax_number": "314-997-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 SCHUETZ RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463538",
            "telephone_number": "314-567-7300",
            "fax_number": "314-997-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO CHIROPRACTIC CENTRE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "ELDER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-567-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "5913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "15344",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4413038",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK GROUP PIN",
            "identifier": "791611",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.