Individual provider Active NPI

James Robert Heisse, DC

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1710639554
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2022000205 Issued in MO
Practice address
9859 Big Bend Blvd Ste 1
Saint Louis, MO 63122-6588
Phone
(314) 909-0404
Fax
(314) 909-0603
NPI assigned
Jan 24, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2022000205 MO Primary

Addresses

Primary practice location

9859 Big Bend Blvd Ste 1
Saint Louis, MO 63122-6588

Mailing address

9859 Big Bend Blvd Ste 1
Saint Louis, MO 63122-6588
Phone (314) 909-0404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122003643 MO Practitioner - Chiropractic 6103278510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Kirk Barron Chiropractic LLCGroup PAC ID 5597868414, 2 clinicians

Practice addresses (Care Compare)

9859 Big Bend Blvd
Saint Louis, MO 63122-6588
Phone (314) 909-0404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022000205MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kirk Barron Chiropractic, LLC Chiropractor CurrentSince Dec 10, 2023 Accepting new patients

Locations

9859 Big Bend Blvd
#1
Saint Louis, MO 63122
Phone (314) 909-0404

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": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1710639554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9859 BIG BEND BLVD STE 1",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226588",
            "telephone_number": "314-909-0404",
            "fax_number": "314-909-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9859 BIG BEND BLVD STE 1",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226588",
            "telephone_number": "314-909-0404",
            "fax_number": "314-909-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISSE",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2022000205",
            "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 24, 2022; 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.