Individual provider Active NPI

Edward Allen Hengel, D.C.

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1669566410
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005518 Issued in MO
Practice address
4006 Bayless Ave
Saint Louis, MO 63125-1314
Phone
(314) 631-5550
Fax
(314) 631-5557
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 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 005518 MO Primary

Addresses

Primary practice location

4006 Bayless Ave
Saint Louis, MO 63125-1314

Mailing address

4006 Bayless Ave
Saint Louis, MO 63125-1314
Phone (314) 631-5550

Other identifiers 1

IdentifierTypeStateIssuer
7788OtherMOANTHEM BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080508000453 MO Practitioner - Chiropractic 6709965254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4006 Bayless Ave
Saint Louis, MO 63125-1314
Phone (314) 631-5550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005518MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Affton Lemay Chiropractic Center LLC Chiropractor CurrentSince Jun 28, 2013 Accepting new patients
Gwinn Chiropractic Center Chiropractor PastSince Oct 15, 2010 Accepting new patients

Locations

4006 Bayless Ave
Saint Louis, MO 63125
Phone (314) 631-5550

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1669566410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 BAYLESS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631251314",
            "telephone_number": "314-631-5550",
            "fax_number": "314-631-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 BAYLESS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631251314",
            "telephone_number": "314-631-5550",
            "fax_number": "314-631-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENGEL",
        "first_name": "EDWARD",
        "middle_name": "ALLEN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "005518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "7788",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.

Verify at the official NPI Registry.