Organization Active NPI

Chiro One Wellness Center of Blue Springs LLC

  • Chiropractor
  • Blue Springs, MO
National Provider Identifier
1639875347
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIRO ONE WELLNESS CENTER OF BLUE SPRINGS LLC
Practice address
1118 NE Coronado Dr
Blue Springs, MO 64014-2944
Phone
(816) 425-0888
NPI assigned
Feb 3, 2023
Last updated
Sep 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Authorized official

Name
Stuart BernsenNPI 1386691566
Title
Ceo
Phone
(630) 229-4430

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 Primary

Addresses

Primary practice location

1118 NE Coronado Dr
Blue Springs, MO 64014-2944

Mailing address

2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230227001345 MO Part B Supplier - Clinic/Group Practice 0345613170 Receives reassigned benefits from 3 practitioners
Practice locations: Blue Springs, MO

National Provider Directory

National Provider Directory

Locations

1114 NE Coronado Dr
Blue Springs, MO 64014
Phone (816) 425-0888

1118 NE Coronado Dr
Blue Springs, MO 64014
Phone (816) 425-0888

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1639875347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 NE CORONADO DR",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142944",
            "telephone_number": "816-425-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF BLUE SPRINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "BERNSEN",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-229-4430"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.