Individual provider Active NPI

Emily Carol Kliethermes, D.C.

  • Chiropractor
  • Jefferson City, MO
National Provider Identifier
1700945722
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2006029077 Issued in MO
Practice address
915 Southwest Blvd
Ste H
Jefferson City, MO 65109-5014
Phone
(573) 635-2225
Fax
(573) 634-5515
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2006029077 MO Primary

Addresses

Primary practice location

915 Southwest Blvd
Ste H
Jefferson City, MO 65109-5014

Mailing address

10411 Tunnel St
Eugene, MO 65032-1003
Phone (573) 635-2225

Other identifiers 1

IdentifierTypeStateIssuer
8H9158OtherTXBCBS OF TEXAS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090420000117 MO Practitioner - Chiropractic 8628003928 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9488TXMDAddiction (Substance Use Disorder) Counselor
2006029077MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Logan University Chiropractor CurrentSince May 1, 2021 Accepting new patients
Jamie Showers DC, LLC Chiropractor CurrentSince Jul 28, 2019 Accepting new patients
Gray Family Chiropractic PLLC Chiropractor PastSince May 1, 2021 Accepting new patients
Parker University Chiropractor PastSince Sep 1, 2005 Accepting new patients

Locations

1851 Schoettler Rd
Chesterfield, MO 63017
Phone (636) 227-2100

915 Southwest Blvd
Ste H
Jefferson Cty, MO 65109
Phone (573) 635-2225

751 W Stadium Blvd
Ste B
Jefferson Cty, MO 65109
Phone (573) 635-2225

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23964/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1700945722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10411 TUNNEL ST",
            "city": "EUGENE",
            "state": "MO",
            "postal_code": "650321003",
            "telephone_number": "573-635-2225",
            "fax_number": "573-634-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SOUTHWEST BLVD",
            "address_2": "STE H",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095014",
            "telephone_number": "573-635-2225",
            "fax_number": "573-634-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIETHERMES",
        "first_name": "EMILY",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2006029077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8H9158",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.