Organization Active NPI

Live Well Be Well LLC

  • Chiropractor
  • Ballwin, MO
National Provider Identifier
1952758674
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2015028570 Issued in MO
Legal business name
LIVE WELL BE WELL LLC
Practice address
14784 Manchester Rd
Ballwin, MO 63011-3708
Phone
(419) 357-2601
NPI assigned
May 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Authorized official

Name
Dr. Bethany Barnes, D.C.
Title
Owner - Chiropractor
Phone
(419) 357-2601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2015028570 MO Primary

Addresses

Primary practice location

14784 Manchester Rd
Ballwin, MO 63011-3708

Mailing address

14784 Manchester Rd
Ballwin, MO 63011-3708
Phone (419) 357-2601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170214000204 MO Part B Supplier - Clinic/Group Practice 6204119464 Receives reassigned benefits from 1 practitioner
Practice locations: Ballwin, MO

National Provider Directory

National Provider Directory

Locations

14784 Manchester Rd
Wildwood, MO 63011
Phone (419) 357-2601

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1952758674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14784 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113708",
            "telephone_number": "419-357-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14784 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113708",
            "telephone_number": "419-357-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL BE WELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-23",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "OWNER - CHIROPRACTOR",
        "authorized_official_telephone_number": "419-357-2601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2015028570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.

Verify at the official NPI Registry.