Organization Active NPI

Vibrant Living Chiropractic PC

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1679879332
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2009024639 Issued in MO
Legal business name
VIBRANT LIVING CHIROPRACTIC PC
Practice address
10315 Clayton Rd
Saint Louis, MO 63131-2907
Phone
(314) 432-2329
Fax
(314) 473-1310
NPI assigned
Jan 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Authorized official

Name
Dr. Michael Thompson, D.C.NPI 1659343952
Title
Owner
Phone
(314) 432-2329

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 2009024639 MO Primary

Addresses

Primary practice location

10315 Clayton Rd
Saint Louis, MO 63131-2907

Mailing address

10315 Clayton Rd
Saint Louis, MO 63131-2907
Phone (314) 432-2329

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110131000484 MO Part B Supplier - Clinic/Group Practice 5799964292 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO; Festus, MO

National Provider Directory

National Provider Directory

Locations

1405 N Truman Blvd
Festus, MO 63028
Phone (314) 432-2329

10315 Clayton Rd
Saint Louis, MO 63131
Phone (314) 432-2329

Practitioners & affiliated clinicians

Practitioners 1

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": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1679879332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10315 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312907",
            "telephone_number": "314-432-2329",
            "fax_number": "314-473-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312907",
            "telephone_number": "314-432-2329",
            "fax_number": "314-473-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT LIVING CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-432-2329",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2009024639",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 28, 2011; 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.