Codey Stephens, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2020042948 Issued in MO

Practice address

219 S Main St
Palmyra, MO 63461-1649

Phone

(573) 769-2400

Fax

(573) 769-0600

NPI assigned

Nov 14, 2018

Last updated

Jun 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1720557291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 S MAIN ST",
            "city": "PALMYRA",
            "state": "MO",
            "postal_code": "634611649",
            "telephone_number": "573-769-2400",
            "fax_number": "573-769-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 S MAIN ST",
            "city": "PALMYRA",
            "state": "MO",
            "postal_code": "634611649",
            "telephone_number": "573-769-2400",
            "fax_number": "573-769-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7097 Old Harding Pike Ste F",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372212800",
            "country_code": "US",
            "telephone_number": "615-646-6700",
            "fax_number": "615-646-3003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "CODEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-14",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "3043",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2020042948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Palmyra, MO
• Providers in Palmyra, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.