Organization Active NPI

Ogle Chiropractic and Rehab Center, LLC

  • Chiropractor
  • Waynesville, MO
National Provider Identifier
1982046728
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
OGLE CHIROPRACTIC AND REHAB CENTER, LLC
Practice address
100 Lafayette Cir Ste a
Waynesville, MO 65583-2430
Phone
(573) 774-4177
Fax
(573) 774-3912
NPI assigned
Jul 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Authorized official

Name
Shane Randall OgleNPI 1760741813
Title
Owner
Phone
(573) 774-4177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

100 Lafayette Cir Ste a
Waynesville, MO 65583-2430

Mailing address

100 Lafayette Cir Ste a
Waynesville, MO 65583-2430
Phone (573) 774-4177

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131022001956 MO Part B Supplier - Clinic/Group Practice 2860627189 Receives reassigned benefits from 2 practitioners
Practice locations: Waynesville, MO

National Provider Directory

National Provider Directory

Locations

320 Ichord Ave
Ste J
Waynesville, MO 65583
Phone (573) 774-4177

103 Ichord Ave
Ste B
Waynesville, MO 65583
Phone (573) 774-4177

24610 Highway 17
Waynesville, MO 65583
Phone (573) 774-4177

100 Lafayette Cir
#A
Waynesville, MO 65583
Phone (573) 774-4177

Practitioners & affiliated clinicians

Practitioners 2

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": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1982046728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LAFAYETTE CIR STE A",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832430",
            "telephone_number": "573-774-4177",
            "fax_number": "573-774-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LAFAYETTE CIR STE A",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832430",
            "telephone_number": "573-774-4177",
            "fax_number": "573-774-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OGLE CHIROPRACTIC AND REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "OGLE",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-774-4177"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.