Active NPI
Susan Lea Roecker, D.C.
- Chiropractor
- Maryville, MO
National Provider Identifier
1861747297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 201201392
- Practice address
- 1206 S Main St
Maryville, MO 64468-2604 - Phone
- (660) 582-5959
- NPI assigned
- Jul 23, 2012
- 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 | 201201392 | MO | Primary |
Addresses
Primary practice location
1206 S Main St
Maryville, MO 64468-2604
Mailing address
1206 S Main St
Maryville, MO 64468-2604
Phone (816) 383-1225
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201201392 | MO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| B-in Motion Chiropractic, Inc | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- St Joseph, MO
- NPI 1023359114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473292800000",
"number": "1861747297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1206 S MAIN ST",
"city": "MARYVILLE",
"state": "MO",
"postal_code": "644682604",
"telephone_number": "816-383-1225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1206 S MAIN ST",
"city": "MARYVILLE",
"state": "MO",
"postal_code": "644682604",
"telephone_number": "660-582-5959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROECKER",
"first_name": "SUSAN",
"middle_name": "LEA",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-23",
"last_updated": "2016-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "201201392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.