Ezell Chiropractic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

2013000467 Issued in MO

Legal business name

EZELL CHIROPRACTIC LLC

Practice address

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

Phone

(636) 916-0660

NPI assigned

Dec 10, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Glenn R. Ezell, D.C.NPI 1942547062

Title

Owner/Doctor

Phone

(636) 916-0660

Specialties & licenses 2

Addresses

Other names 1

• Ezell Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Glenn R. Ezell, D.C.

  • Chiropractor
  • Saint Charles, MO
  • NPI 1942547062
  Medicare reassignment NPD Authorized official
• Mahir Hanna Awwad, DC

  • Chiropractor
  • Saint Charles, MO
  • NPI 1821137944
  NPD
• Kathryn Schollmeyer, PT, DPT

  • Physical Therapist
  • Saint Charles, MO
  • NPI 1134643067
  NPD
• Matthew Alexander Walter, D.C.

  • Chiropractor
  • Saint Charles, MO
  • NPI 1063388130
  NPD

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1982035440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 1ST CAPITOL DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633015805",
            "telephone_number": "636-916-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 1ST CAPITOL DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633015805",
            "telephone_number": "636-916-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZELL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "EZELL",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "636-916-0660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MO",
            "license": "2013000467",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MO",
            "license": "2013000467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ezell Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ezell Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Kay Everly Ramirez
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• Eye Shoppe, Inc.
• Eye Specialists of Saint Charles, LLC
• Glenn R. Ezell, D.C.
• 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

• Primary Care Clinic/Center in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Primary Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.