Raintree Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2005005613 Issued in MO

Legal business name

RAINTREE CHIROPRACTIC CENTER

Practice address

4 Hickory Ridge Rd
Suite #800
Hillsboro, MO 63050-5100

Phone

(636) 797-5100

Fax

(636) 797-2745

NPI assigned

Aug 21, 2007

Last updated

Aug 21, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stacey A. Maxwell-Krockenberger, D.C.,M.T.A.A.,L.M.T.

Title

Owner

Phone

(636) 797-5100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1679766810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HICKORY RIDGE RD",
            "address_2": "SUITE #800",
            "city": "HILLSBORO",
            "state": "MO",
            "postal_code": "630505100",
            "telephone_number": "636-797-5100",
            "fax_number": "636-797-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HICKORY RIDGE RD",
            "address_2": "SUITE #800",
            "city": "HILLSBORO",
            "state": "MO",
            "postal_code": "630505100",
            "telephone_number": "636-797-5100",
            "fax_number": "636-797-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINTREE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "MAXWELL-KROCKENBERGER",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-797-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C.,M.T.A.A.,L.M.T."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2005005613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Hillsboro, MO
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.