Core Chiropractic & Acupuncture Corp

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2012030950 Issued in MO

Legal business name

CORE CHIROPRACTIC & ACUPUNCTURE CORP

Practice address

500 Jungermann Rd Ste 200
Saint Peters, MO 63376-2774

Phone

(636) 317-6311

Fax

(636) 317-6311

NPI assigned

Sep 24, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Shanna L Wilde

Title

Billing Specialist/Manager

Phone

(636) 495-6158

Specialties & licenses 1

Addresses

Other names 1

• Doc On Demand, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

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

• Lynn Vitale, D.C.

  • Chiropractor
  • Saint Peters, MO
  • NPI 1972852192
  Medicare reassignment
• Gary James Hagner, D.C.

  • Chiropractor
  • Saint Peters, MO
  • NPI 1154452647
  NPD (past)

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1811248404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 JUNGERMANN RD STE 200",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762774",
            "telephone_number": "636-317-6311",
            "fax_number": "636-317-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 JUNGERMANN RD STE 200",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762774",
            "telephone_number": "636-317-6311",
            "fax_number": "636-317-6311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4087 Veterans Memorial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633766421",
            "country_code": "US",
            "telephone_number": "636-447-1717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4139 Mexico Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633766410",
            "country_code": "US",
            "telephone_number": "636-447-1717",
            "fax_number": "636-922-9124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5433 Butler Hill Road",
            "address_purpose": "LOCATION",
            "city": "St Louis",
            "state": "MO",
            "postal_code": "631286312",
            "country_code": "US",
            "telephone_number": "314-520-3616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORE CHIROPRACTIC & ACUPUNCTURE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-24",
        "last_updated": "2022-07-21",
        "certification_date": "2020-12-31",
        "status": "A",
        "authorized_official_last_name": "WILDE",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING SPECIALIST/MANAGER",
        "authorized_official_telephone_number": "636-495-6158",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2012030950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doc On Demand, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Cool Nurses of America
• Timothy J P Cooper, MD
• Lisa M Cooseman, OTRL, MS
• Jeffrey G Copeland, M.D.
• Aaron Coppedge
• Core Concepts Chiropractic
• Heather Anne Cosby, MSW, LCSW
• Pamela Coslick, O.D.
• Costco Wholesale Corporation
• Costco Wholesale Corporation

• Chiropractor in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.