Individual provider Active NPI

Christopher Ryan Weilandich

  • Chiropractor
  • Des Peres, MO
National Provider Identifier
1699120097
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2020031483 Issued in MO
Practice address
2190 S Mason Rd Ste 302
Des Peres, MO 63131-1637
Phone
(636) 629-2414
NPI assigned
May 4, 2016
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2015038419 MO
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 2020031483 MO Primary

Addresses

Primary practice location

2190 S Mason Rd Ste 302
Des Peres, MO 63131-1637

Mailing address

2718 Red Cedar Parc Dr S
O Fallon, MO 63368-6607
Phone (636) 487-6207

Other practice location 1

222 S 2nd St
Saint Charles, MO 63301-2809
Phone (636) 947-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020031483MOMDChiropractor
2015038419MOMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Coleman Chiropractic, PC Chiropractor CurrentSince Oct 11, 2020 Accepting new patients

Locations

2190 S Mason Rd
Ste 302
Des Peres, MO 63131
Phone (636) 629-2414

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1699120097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718 RED CEDAR PARC DR S",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686607",
            "telephone_number": "636-487-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 S MASON RD STE 302",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311637",
            "telephone_number": "636-629-2414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 S 2nd St",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633012809",
            "country_code": "US",
            "telephone_number": "636-947-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEILANDICH",
        "first_name": "CHRISTOPHER",
        "middle_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2015038419",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2020031483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Peres, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.