Individual provider Active NPI

Caleb Mark Bryant, DC

  • Chiropractor
  • O Fallon, MO
National Provider Identifier
1861996308
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2016033338 Issued in MO
Practice address
1297 Bryan Rd
O Fallon, MO 63366-3729
Phone
(636) 294-0070
NPI assigned
Mar 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2016033338 MO Primary

Addresses

Primary practice location

1297 Bryan Rd
O Fallon, MO 63366-3729

Mailing address

1297 Bryan Rd
O Fallon, MO 63366-3729
Phone (636) 294-0070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191112000731 MO Practitioner - Chiropractic 3274965306 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1297 Bryan Rd
O Fallon, MO 63366-3729
Phone (636) 294-0070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Friedrichs Physical Therapy, LLC CurrentSince Nov 7, 2019 Accepting new patients
Bryant Chiro LLC Chiropractor CurrentSince Oct 1, 2024 Accepting new patients
Synergy Chiropractic Center, LLC Chiropractor CurrentSince Nov 7, 2019 Accepting new patients

Locations

124 Old W Terra Ln
O Fallon, MO 63366
Phone (636) 339-2327

1297 Bryan Rd
O Fallon, MO 63366
Phone (636) 294-0070

1420 W Meyer Rd
Wentzville, MO 63385
Phone (573) 221-0304

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1861996308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1297 BRYAN RD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663729",
            "telephone_number": "636-294-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 BRYAN RD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663729",
            "telephone_number": "636-294-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "CALEB",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2016033338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.