Active NPI
Steven Joseph Tavernaro, D.C., MS
- Chiropractor
- Columbia, MO
National Provider Identifier
1639760168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2020038668
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020038668 | Other | MO | STATE LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Columbia | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Chiropractic Center | Chiropractor | Current | 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.
-
- Chiropractor
- Fulton, MO
- NPI 1881411395
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.