Organization Active NPI

Siraguso Chiropractic Inc.

  • Sports Physician Chiropractor
  • Liberty, MO
National Provider Identifier
1811177967
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
006282 Issued in MO
Legal business name
SIRAGUSO CHIROPRACTIC INC.
Practice address
113 Blue Jay Dr
Suite 106
Liberty, MO 64068-1997
Phone
(816) 415-2900
Fax
(816) 415-2903
NPI assigned
Nov 6, 2007
Last updated
Dec 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Authorized official

Name
Dr. Vincent Carl Siraguso, D.C.NPI 1801015243
Title
Owner/Physician
Phone
(816) 415-2900

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
Sports Physician Chiropractor 111NS0005X 006282 MO Primary

Addresses

Primary practice location

113 Blue Jay Dr
Suite 106
Liberty, MO 64068-1997

Mailing address

113 Blue Jay Dr
Suite 106
Liberty, MO 64068-1997
Phone (816) 415-2900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080117000292 MO Part B Supplier - Clinic/Group Practice 0446331276 Receives reassigned benefits from 1 practitioner
Practice locations: Liberty, MO

National Provider Directory

National Provider Directory

Locations

113 Blue Jay Dr
Ste 106
Liberty, MO 64068
Phone (816) 415-2400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1811177967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 BLUE JAY DR",
            "address_2": "SUITE 106",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681997",
            "telephone_number": "816-415-2900",
            "fax_number": "816-415-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 BLUE JAY DR",
            "address_2": "SUITE 106",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681997",
            "telephone_number": "816-415-2900",
            "fax_number": "816-415-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIRAGUSO CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "SIRAGUSO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "816-415-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MO",
            "license": "006282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; 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.