Individual provider Active NPI

Bryan Allen Deloney, D.C.

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1871720193
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2010009588 Issued in MO
Practice address
12977 N 40 Dr Ste 105
Saint Louis, MO 63141-8654
Phone
(636) 590-4686
NPI assigned
Jun 12, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 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 2010009588 MO Primary

Addresses

Primary practice location

12977 N 40 Dr Ste 105
Saint Louis, MO 63141-8654

Mailing address

126 Hilltown Village Ctr
Chesterfield, MO 63017-0709
Phone (314) 226-4492

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000194 MO Practitioner - Chiropractic 4082730999 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2010009588MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Simply Health Integrated Medical LLC CurrentSince Sep 17, 2020 Accepting new patients

Locations

126 Hilltown Village Ctr
Chesterfield, MO 63017
Phone (314) 226-4492

12977 N 40 Dr
Ste 105
Saint Louis, MO 63141
Phone (314) 226-4492

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1871720193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 HILLTOWN VILLAGE CTR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630170709",
            "telephone_number": "314-226-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12977 N 40 DR STE 105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418654",
            "telephone_number": "636-590-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELONEY",
        "first_name": "BRYAN",
        "middle_name": "ALLEN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2010009588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.