Organization Active NPI

Epic Life Chiropractic & Wellness LLC

  • Chiropractor
  • Florissant, MO
National Provider Identifier
1780040659
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EPIC LIFE CHIROPRACTIC & WELLNESS LLC
Practice address
869 Saint Francois St
Florissant, MO 63031-4923
Phone
(314) 839-8884
NPI assigned
Jan 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Authorized official

Name
Mark Jacob Sehnert, D.C.NPI 1205004462
Title
Owner
Phone
(314) 839-8884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

869 Saint Francois St
Florissant, MO 63031-4923

Mailing address

26421 Southfield Rd
Lathrup Village, MI 48076-4528
Phone (248) 905-5066

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160607000680 MO Part B Supplier - Clinic/Group Practice 3476843228 Receives reassigned benefits from 1 practitioner
Practice locations: Florissant, MO

National Provider Directory

National Provider Directory

Locations

745 Rue Saint Francois St
Florissant, MO 63031
Phone (314) 839-8884

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1780040659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26421 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480764528",
            "telephone_number": "248-905-5066",
            "fax_number": "248-905-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 SAINT FRANCOIS ST",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630314923",
            "telephone_number": "314-839-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC LIFE CHIROPRACTIC & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-08",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "SEHNERT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-839-8884",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.