Individual provider Active NPI

Richard Wayne Cranwell, D.C.

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1912038308
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03791 Issued in MO
Practice address
11705 Gravois Road
St Louis, MO 63127
Phone
(314) 843-3039
Fax
(314) 843-9604
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 03791 MO Primary

Addresses

Primary practice location

11705 Gravois Road
St Louis, MO 63127

Mailing address

11705 Gravois Road
St Louis, MO 63127
Phone (314) 843-3039

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080304000422 MO Practitioner - Chiropractic 8325123136 Practice locations: Saint Louis, MO

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1976
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11705 Gravois Rd
Saint Louis, MO 63127-1803
Phone (314) 843-3039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03791MOMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1912038308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11705 GRAVOIS ROAD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63127",
            "telephone_number": "314-843-3039",
            "fax_number": "314-843-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 GRAVOIS ROAD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63127",
            "telephone_number": "314-843-3039",
            "fax_number": "314-843-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANWELL",
        "first_name": "RICHARD",
        "middle_name": "WAYNE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "03791",
            "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 Sep 4, 2014; 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.