NPIMap

Organization Active NPI

Back in Action Chiropractic LLC

  • Chiropractor
  • Warsaw, MO
National Provider Identifier
1679083588
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2015044724 Issued in MO
Legal business name
BACK IN ACTION CHIROPRACTIC LLC
Practice address
204 W Seminary St
Warsaw, MO 65355
Phone
(660) 223-0199
Fax
(660) 438-6943
NPI assigned
Oct 5, 2017
Last updated
Oct 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Dr. Tyrel James Reichert, DCNPI 1164947032
Title
Owner/Operator
Phone
(660) 223-0199

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
Chiropractor 111N00000X 2015044724 MO Primary

Addresses

Primary practice location

204 W Seminary St
Warsaw, MO 65355

Mailing address

PO Box 729
Warsaw, MO 65355-0729
Phone (660) 223-0199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171127001435 MO Part B Supplier - Clinic/Group Practice 2062779291 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Sedalia, MO; Warsaw, MO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Back in Action Chiropractic LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1501 S Grand Ave
Sedalia, MO 65301
Phone (660) 620-0276

1650 Commercial St
Warsaw, MO 65355

1650 Commercial St
#B
Warsaw, MO 65355
Phone (660) 620-0276

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1679083588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "WARSAW",
            "state": "MO",
            "postal_code": "653550729",
            "telephone_number": "660-223-0199",
            "fax_number": "660-438-6943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W SEMINARY ST",
            "city": "WARSAW",
            "state": "MO",
            "postal_code": "65355",
            "telephone_number": "660-223-0199",
            "fax_number": "660-438-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN ACTION CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-05",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "REICHERT",
        "authorized_official_first_name": "TYREL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "660-223-0199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2015044724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.