Active NPI
Michelle Marie Brungart, DC
- Chiropractor
- Kirkwood, MO
National Provider Identifier
1780299164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2020013194
- Practice address
- 12201 Big Bend Rd Ste 200
Kirkwood, MO 63122-6831 - Phone
- (314) 805-7837
- NPI assigned
- Sep 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2020013194 | MO | Primary |
Addresses
Primary practice location
12201 Big Bend Rd Ste 200
Kirkwood, MO 63122-6831
Mailing address
12201 Big Bend Rd Ste 200
Kirkwood, MO 63122-6831
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020013194 | Other | MO | CHIROPRACTIC LICENSE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Michelle.Brungart@logan.edu | ||
| Direct Messaging Address | Michelle.brungart@logan.edu |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020013194 | MO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599782400000",
"number": "1780299164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12201 BIG BEND RD STE 200",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631226831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12201 BIG BEND RD STE 200",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631226831",
"telephone_number": "314-805-7837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNGART",
"first_name": "MICHELLE",
"middle_name": "MARIE",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-11",
"last_updated": "2020-09-11",
"certification_date": "2020-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2020013194",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIROPRACTIC LICENSE",
"identifier": "2020013194",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Michelle.Brungart@logan.edu",
"affiliation": "N",
"address_1": "12201 Big Bend Rd Ste 200",
"city": "Kirkwood",
"state": "MO",
"country_code": "US",
"postal_code": "631226831",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Michelle.brungart@logan.edu",
"affiliation": "N",
"address_1": "12201 Big Bend Rd Ste 200",
"city": "Kirkwood",
"state": "MO",
"country_code": "US",
"postal_code": "631226831",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kirkwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.