Individual provider Active NPI

Michelle Ann Mashinter, D.C.

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1780053140
Registry record updated Nov 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2015031527 Issued in MO
Practice address
2440 Executive Dr Ste 100
Saint Charles, MO 63303-5607
Phone
(636) 244-4994
Fax
(636) 244-3134
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2015031527 MO Primary

Addresses

Primary practice location

2440 Executive Dr Ste 100
Saint Charles, MO 63303-5607

Mailing address

2440 Executive Dr Ste 100
Saint Charles, MO 63303-5607
Phone (636) 244-4994

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230512002091 MO Practitioner - Chiropractic 7719343912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Ag Management Group LLCGroup PAC ID 2466638317, 3 clinicians

Practice addresses (Care Compare)

2440 Executive Dr
Suite 100
Saint Charles, MO 63303-5607
Phone (636) 244-4994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015031527MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ag Management Group LLC Chiropractor CurrentSince Jan 28, 2023 Accepting new patients

Locations

2440 Executive Dr
Ste 100
Saint Charles, MO 63303
Phone (636) 244-4994

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636761600000",
    "number": "1780053140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 EXECUTIVE DR STE 100",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035607",
            "telephone_number": "636-244-4994",
            "fax_number": "636-244-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 EXECUTIVE DR STE 100",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035607",
            "telephone_number": "636-244-4994",
            "fax_number": "636-244-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHINTER",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2021-11-13",
        "certification_date": "2021-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2015031527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2021; 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.