Kenneth Gerard Wolf, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-009874 Issued in IL

Practice address

1276A Jungermann Rd
Saint Peters, MO 63376-6961

Phone

(314) 707-5575

Fax

(636) 794-3012

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kenneth G. Wolf, D.C., L.L.C.

  • Chiropractor
  • Chesterfield, MO
  • NPI 1336244342
  NPD (past) Authorized official
• Jerseyville Pain Management Center, S.C.

  • Chiropractor
  • Wood River, IL
  • NPI 1063470524
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1932215498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4627 TAUNEYBROOK DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282219",
            "telephone_number": "314-707-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276A JUNGERMANN RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766961",
            "telephone_number": "314-707-5575",
            "fax_number": "636-794-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "KENNETH",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2006003308",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038009874",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Winzen, LPC
• Melissa Wirtz
• Krista D Woelfel, MSN, FNP
• Whitney Hoyt Wojahn, M.A.
• Alexander Wojtyna, DDS
• Katherine Fay Wolken, D.D.S.
• Christian Wollmershauser, ATC,LAT,BS
• Womens Care Specialists, LLC
• Leann Elizabeth Wood, P.T.
• Shanee Nicole Woodard, R.N

• Chiropractor in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.