Active NPI
Glen Scott Hudder, D.C.
- Chiropractor
- Saint Louis, MO
National Provider Identifier
1710042908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2000153527
- Practice address
- 8112 Olive Blvd
Saint Louis, MO 63130-2023 - Phone
- (314) 567-9990
- Fax
- (314) 567-9991
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2000153527 | MO | Primary |
Addresses
Primary practice location
8112 Olive Blvd
Saint Louis, MO 63130-2023
Mailing address
8112 Olive Blvd
Saint Louis, MO 63130-2023
Phone (314) 567-9990
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44-00153 | Other | MO | UNITED HEALTHCARE |
| 143517 | Other | MO | BLUE CROSS BLUE SHIELD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710042908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8112 OLIVE BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631302023",
"telephone_number": "314-567-9990",
"fax_number": "314-567-9991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8112 OLIVE BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631302023",
"telephone_number": "314-567-9990",
"fax_number": "314-567-9991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDDER",
"first_name": "GLEN",
"middle_name": "SCOTT",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2000153527",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "44-00153",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "143517",
"state": "MO"
}
],
"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 Jul 8, 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.