Active NPI
Emmett Ray Reary, D.C.
- Chiropractor
- Salem, MO
National Provider Identifier
1881676781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 003961
- Practice address
- 216 W 3Rd St
Salem, MO 65560-1336 - Phone
- (573) 729-2828
- Fax
- (573) 729-0024
- NPI assigned
- Nov 16, 2005
- Last updated
- Nov 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 003961 | MO | Primary |
Addresses
Primary practice location
216 W 3Rd St
Salem, MO 65560-1336
Mailing address
216 W 3Rd St
Salem, MO 65560-1336
Phone (573) 729-2828
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00450148 | Other | MO | PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040123000976 | MO | Practitioner - Chiropractic | 8628970175 | Practice locations: Salem, MO |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003961 | MO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1881676781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 W 3RD ST",
"city": "SALEM",
"state": "MO",
"postal_code": "655601336",
"telephone_number": "573-729-2828",
"fax_number": "573-729-0024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 W 3RD ST",
"city": "SALEM",
"state": "MO",
"postal_code": "655601336",
"telephone_number": "573-729-2828",
"fax_number": "573-729-0024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARY",
"first_name": "EMMETT",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "003961",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "P00450148",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.