Latisha De'Bose, DC
Individual provider Active NPI Chiropractor · Belton, MO
NPI 1649958737 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1649958737
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2023025309 (MO)
- Practice address
- 114 Congress St
Belton, MO 64012-2400 - Phone
- (816) 331-8900
- NPI assigned
- Jul 7, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Kansas City, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Chiro One Wellness Center of Schaumburg West Clinic LLC
Practice addresses (Care Compare)
9 W Schaumburg Rd
Schaumburg, IL 60194-3506
Phone (847) 857-5692
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260209000935 | IL | Practitioner - Chiropractic | 8921460577 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiro One Wellness Center of Schaumburg West Clinic, LLC | Chiropractor | Current |
Accepting new patients |
| Abundant Life Chiropractic, LLC | Chiropractor | Past |
Accepting new patients |
Locations
9 W Schaumburg Rd
Schaumburg, IL 60194
Phone (847) 301-0499
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2023025309 | MO | Yes |
Addresses
Primary practice location
114 Congress St
Belton, MO 64012-2400
Mailing address
6405 E 163Rd St Unit 4209
Belton, MO 64012-1587
Other providers in Belton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.