South City Chiropractic Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SOUTH CITY CHIROPRACTIC CLINIC LLC

Practice address

6841 Gravois Ave
Saint Louis, MO 63116-1162

Phone

(317) 353-4357

NPI assigned

Dec 22, 2009

Last updated

Nov 20, 2024By 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

Christopher GaddieNPI 1194995191

Title

Owner

Phone

(314) 353-4357

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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.

• Christopher Andrew Gaddie II, D.C.

  • Chiropractor
  • Saint Louis, MO
  • NPI 1194995191
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1639408636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6841 GRAVOIS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631161162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6841 GRAVOIS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631161162",
            "telephone_number": "317-353-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CITY CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-22",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "GADDIE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-353-4357"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.