Individual provider Active NPI

Sarah Elizabeth Rebello, DC

  • Chiropractor
  • Bridgeton, MO
National Provider Identifier
1821410960
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2013045694 Issued in MO
Practice address
11901 Saint Charles Rock Rd
Bridgeton, MO 63044-2623
Phone
(314) 298-1400
NPI assigned
Jan 8, 2014
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2013045694 MO Primary

Addresses

Primary practice location

11901 Saint Charles Rock Rd
Bridgeton, MO 63044-2623

Mailing address

11901 Saint Charles Rock Rd
Bridgeton, MO 63044-2623
Phone (314) 298-1400

Other practice location 1

225 S Meramec Ave Ste 306
Saint Louis, MO 63105-3511
Phone (314) 720-5390

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140318001997 MO Practitioner - Chiropractic 7113158064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Smart Pain Solutions LLCGroup PAC ID 4284815721, 4 clinicians

Practice addresses (Care Compare)

11901 Saint Charles Rock Rd
Bridgeton, MO 63044-2623
Phone (314) 298-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013045694MOMDChiropractor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1821410960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 SAINT CHARLES ROCK RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442623",
            "telephone_number": "314-298-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 SAINT CHARLES ROCK RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442623",
            "telephone_number": "314-298-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 S Meramec Ave Ste 306",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631053511",
            "country_code": "US",
            "telephone_number": "314-720-5390",
            "fax_number": "314-721-6903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REBELLO",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2013045694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.