St. Louis Spine & Health Associates

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CE006255 Issued in MO

Legal business name

ST. LOUIS SPINE & HEALTH ASSOCIATES

Practice address

12401 Olive Blvd Ste 202
Creve Coeur, MO 63141-5448

Phone

(314) 576-1495

Fax

(314) 576-2804

NPI assigned

Nov 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kriston Shane Neifert, D.C.

Title

Owner

Phone

(314) 576-1495

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracie Virginia Fleshman, D.C.

  • Chiropractor
  • Maryland Heights, MO
  • NPI 1811979032
  NPD (past)
• Sung Kwang Lee, D.C.

  • Chiropractor
  • Creve Coeur, MO
  • NPI 1265663462
  NPD (past)

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1942480256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD STE 202",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415448",
            "telephone_number": "314-576-1495",
            "fax_number": "314-576-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD STE 202",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415448",
            "telephone_number": "314-576-1495",
            "fax_number": "314-576-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS SPINE & HEALTH ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "NEIFERT",
        "authorized_official_first_name": "KRISTON",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-576-1495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE006255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "155354",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "20189",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "285150",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350056741",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275529745",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1130904",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4403250",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "633007106",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St Louis Kidney, LLC
• St Louis Pet Centers, LLC
• St Lukes Immediate Care LLC
• St. Louis Center for Cognitive Health, LLC
• St. Louis Laser LLC
• St. Louis Spine Surgery Center, LLC
• St. Louis Stress Clinic LLC
• St. Louis Surgical Center, LC
• St. Lukes Center for Diagnostic Imaging LLC
• Kayla Kishon Stallings

• Chiropractor in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.