Glenn R. Ezell, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2013000467 Issued in MO

Practice address

2201 1St Capitol Dr Ste 101
Saint Charles, MO 63301-5805

Phone

(636) 485-6661

Fax

(636) 916-0668

NPI assigned

Jan 9, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Ezell Chiropractic LLC

  • Primary Care Clinic/Center
  • Saint Charles, MO
  • NPI 1982035440
  Medicare reassignment NPD Authorized official
• A B Chiropractic Family & Wellness, LLC

  • Chiropractor
  • Saint Charles, MO
  • NPI 1902938327
  NPD (past)

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1942547062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 1ST CAPITOL DR STE 101",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633015805",
            "telephone_number": "636-485-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 1ST CAPITOL DR STE 101",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633015805",
            "telephone_number": "636-485-6661",
            "fax_number": "636-916-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZELL",
        "first_name": "GLENN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-09",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2013000467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excel Healthcare
• Excel Healthcare
• Eye Shoppe, Inc.
• Eye Specialists of Saint Charles, LLC
• Ezell Chiropractic LLC
• Jeffrey Allen Fabbiano, P.L.P.C
• Facts of Life in Home Service, Inc.
• Patrick Daniel Fagan, D.P.T.
• Faith Hope & Love Homecare 2 LLC
• Faith, Hope & Love Homecare, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.