Individual provider Active NPI

Robert Edminston, D.C.

  • Chiropractor
  • Valley Park, MO
National Provider Identifier
1649295700
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CE005206 Issued in MO
Practice address
22 Meramec Valley PLZ
Valley Park, MO 63088-2112
Phone
(636) 225-3030
Fax
(636) 225-3516
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CE005206 MO Primary

Addresses

Primary practice location

22 Meramec Valley PLZ
Valley Park, MO 63088-2112

Mailing address

22 Meramec Valley PLZ
Valley Park, MO 63088-2112
Phone (636) 225-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CE005206MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Health Group Medical Inc PastSince Mar 29, 2015 Accepting new patients
Physicians Health Group, LLC PastSince Jun 1, 2004 Accepting new patients

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1649295700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MERAMEC VALLEY PLZ",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630882112",
            "telephone_number": "636-225-3030",
            "fax_number": "636-225-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MERAMEC VALLEY PLZ",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630882112",
            "telephone_number": "636-225-3030",
            "fax_number": "636-225-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMINSTON",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE005206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Park, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.