Individual provider Active NPI

Joseph Anthony Di Carlo, D.C.

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1699868182
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CE005624 Issued in MO
Practice address
56 Portwest CT
Saint Charles, MO 63303-5985
Phone
(636) 949-5700
Fax
(636) 916-3735
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CE005624 MO Primary

Addresses

Primary practice location

56 Portwest CT
Saint Charles, MO 63303-5985

Mailing address

56 Portwest CT
Saint Charles, MO 63303-5985
Phone (636) 949-5700

Other identifiers 2

IdentifierTypeStateIssuer
43-1768965OtherMOFEDERAL TAX ID #
5662OtherMOBLUE CROSS/ BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120105000825 MO Practitioner - Chiropractic 3375719727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

56 Portwest CT
Saint Charles, MO 63303-5985
Phone (636) 949-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5624MOMDAddiction (Substance Use Disorder) Counselor
CE005624MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dicarlo Chiropractic Center P C Chiropractor CurrentSince Jan 1, 2012 Accepting new patients

Locations

56 Portwest Ct
Saint Charles, MO 63303
Phone (636) 949-5700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1699868182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 PORTWEST CT",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035985",
            "telephone_number": "636-949-5700",
            "fax_number": "636-916-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 PORTWEST CT",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035985",
            "telephone_number": "636-949-5700",
            "fax_number": "636-916-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI CARLO",
        "first_name": "JOSEPH",
        "middle_name": "ANTHONY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE005624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID #",
            "identifier": "43-1768965",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "5662",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.