Individual provider Active NPI

Steven Joseph Tavernaro, D.C., MS

  • Chiropractor
  • Columbia, MO
National Provider Identifier
1639760168
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2020038668 Issued in MO
Practice address
21 Conley Rd Ste L2
Columbia, MO 65201-6484
Phone
(314) 540-8371
NPI assigned
Jan 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2020038668 MO Primary

Addresses

Primary practice location

21 Conley Rd Ste L2
Columbia, MO 65201-6484

Mailing address

2401 W Broadway Apt 1107
Columbia, MO 65203-1252
Phone (816) 200-8310

Other identifiers 1

IdentifierTypeStateIssuer
2020038668OtherMOSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Columbia Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250207000341 MO Practitioner - Chiropractic 7214467117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

602 Market St
Fulton, MO 65251-1928
Phone (573) 310-6042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Chiropractic Center Chiropractor CurrentSince Dec 23, 2024 Accepting new patients

Locations

602 Market St
Fulton, MO 65251
Phone (573) 310-6042

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1639760168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BROADWAY APT 1107",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031252",
            "telephone_number": "816-200-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CONLEY RD STE L2",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016484",
            "telephone_number": "314-540-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERNARO",
        "first_name": "STEVEN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C., MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2020038668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2020038668",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "endpointDescription": "dr.steven.tavernaro@thejoint.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Conley Rd Ste L2",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652016484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.