Jacob Hedges Utterback, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2007000279 Issued in MO

Practice address

140 W Adams Ave
Kirkwood, MO 63122-4023

Phone

(314) 965-8084

Fax

(314) 965-8612

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Utterback Chiropractic, LLC

  • Clinic/Center
  • Kirkwood, MO
  • NPI 1316174535
  Medicare reassignment NPD Authorized official
• Crossroads Family Chiropractic, LLC

  • Chiropractor
  • Creve Coeur, MO
  • NPI 1356584460
  NPD (past)
• Metro Chiropractic Centre, Inc.

  • Chiropractor
  • Saint Louis, MO
  • NPI 1639218324
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1730228248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W ADAMS AVE",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631224023",
            "telephone_number": "314-965-8084",
            "fax_number": "314-965-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W ADAMS AVE",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631224023",
            "telephone_number": "314-965-8084",
            "fax_number": "314-965-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTERBACK",
        "first_name": "JACOB",
        "middle_name": "HEDGES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007000279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "791611",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine M Tuhill, RPH
• Amy Turk
• Sarah Elizabeth Tyndall, LCSW
• Catherine A Upton
• Utterback Chiropractic, LLC
• Meika Valerio, BCBA
• Ramakrishna Prasad Vallurupalli, MD
• Penny Dawn Valvero, LPC
• Angela Van Booven, MA
• John C Vandover, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.