NPIMap

Organization Active NPI

Rupp Chiropractic LLC

  • Chiropractor
  • Chesterfield, MO
National Provider Identifier
1659612901
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2013001163 Issued in MO
Legal business name
RUPP CHIROPRACTIC LLC
Practice address
13720 Olive Blvd
Chesterfield, MO 63017-2602
Phone
(314) 896-3550
Fax
(314) 255-2390
NPI assigned
Mar 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Krystal Ann Phillips, D.C.NPI 1619215191
Title
Physician
Phone
(314) 896-3550

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 2013001163 MO Primary

Addresses

Primary practice location

13720 Olive Blvd
Chesterfield, MO 63017-2602

Mailing address

13720 Olive Blvd
Chesterfield, MO 63017-2602
Phone (314) 896-3550

Other practice location 1

14377 Woodlake Dr
Suite 110
Chesterfield, MO 63017-5735
Phone (314) 628-9895

Other names 2

  • Back to Life Chiropractic Doing business as
  • Chiropractic Physicians Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130604000529 MO Part B Supplier - Clinic/Group Practice 3971741802 Receives reassigned benefits from 1 practitioner
Practice locations: Chesterfield, MO

National Provider Directory

National Provider Directory

Locations

13720 Olive Blvd
Chesterfield, MO 63017
Phone (314) 896-3550

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1659612901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13720 OLIVE BLVD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172602",
            "telephone_number": "314-896-3550",
            "fax_number": "314-255-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13720 OLIVE BLVD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172602",
            "telephone_number": "314-896-3550",
            "fax_number": "314-255-2390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14377 Woodlake Dr",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630175735",
            "country_code": "US",
            "telephone_number": "314-628-9895",
            "fax_number": "314-628-9874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RUPP CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "314-896-3550",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2013001163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back to Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chiropractic Physicians Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.