Individual provider Active NPI

David Gerard Hartmann, DC

  • Chiropractor
  • St Louis, MO
National Provider Identifier
1720108004
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005961 Issued in MO
Practice address
5226 S Lindbergh Blvd
St Louis, MO 63126-3519
Phone
(314) 842-6777
Fax
(314) 842-0377
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 005961 MO Primary

Addresses

Primary practice location

5226 S Lindbergh Blvd
St Louis, MO 63126-3519

Mailing address

5226 S Lindbergh Blvd
St Louis, MO 63126-3519
Phone (314) 842-6777

Other identifiers 3

IdentifierTypeStateIssuer
10851409OtherAETNA
3650OtherBLUE CROSS BLUE SHIELD
181680OtherHEALTHLINK

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
005961MOMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720108004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5226 S LINDBERGH BLVD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631263519",
            "telephone_number": "314-842-6777",
            "fax_number": "314-842-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5226 S LINDBERGH BLVD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631263519",
            "telephone_number": "314-842-6777",
            "fax_number": "314-842-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMANN",
        "first_name": "DAVID",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "005961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "10851409",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3650",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "181680",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St 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.

Verify at the official NPI Registry.