Active NPI
Kyle Matthew Tiefel, D.C.
- Chiropractor
- Fenton, MO
National Provider Identifier
1861751166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2012013166
- Practice address
- 1525 Bowles Ave Ste C
Fenton, MO 63026-2310 - Phone
- (636) 343-5500
- Fax
- (636) 343-5506
- NPI assigned
- May 8, 2012
- Last updated
- May 8, 2012
- Sex
- Male
- 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 | 2012013166 | MO | Primary |
Addresses
Primary practice location
1525 Bowles Ave Ste C
Fenton, MO 63026-2310
Mailing address
1525 Bowles Ave Ste C
Fenton, MO 63026-2310
Phone (636) 343-5500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012013166 | MO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hamilton County Chiropractic | Chiropractor | Current | Accepting new patients |
| Dyer Chiropractic Clinic P C | Past | Accepting new patients |
Locations
33 E County Line Rd
Ste A
Greenwood, IN 46143
Phone (317) 776-1061
220 Lakeview Dr
Noblesville, IN 46060
Phone (317) 776-1061
Organizations & group practices 2
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.
-
dba Midwest Sport and Spine Center
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Noblesville, IN
- NPI 1285797746
Chiropractor
-
- Rehabilitation Chiropractor
- Greenwood, IN
- NPI 1881870814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336435200000",
"number": "1861751166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 BOWLES AVE STE C",
"city": "FENTON",
"state": "MO",
"postal_code": "630262310",
"telephone_number": "636-343-5500",
"fax_number": "636-343-5506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 BOWLES AVE STE C",
"city": "FENTON",
"state": "MO",
"postal_code": "630262310",
"telephone_number": "636-343-5500",
"fax_number": "636-343-5506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIEFEL",
"first_name": "KYLE",
"middle_name": "MATTHEW",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-08",
"last_updated": "2012-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2012013166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.