Active NPI
Eric Wayne Reavis, D.C.
- Chiropractor
- Springfield, MO
National Provider Identifier
1982724787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2007008411
- Practice address
- 1342 E Primrose St
Suite a
Springfield, MO 65804-4279 - Phone
- (417) 877-1300
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2007008411 | MO | Primary |
Addresses
Primary practice location
1342 E Primrose St
Suite a
Springfield, MO 65804-4279
Mailing address
1342 E Primrose St
Suite a
Springfield, MO 65804-4279
Phone (417) 877-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007008411 | MO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982724787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1342 E PRIMROSE ST",
"address_2": "SUITE A",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044279",
"telephone_number": "417-877-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1342 E PRIMROSE ST",
"address_2": "SUITE A",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044279",
"telephone_number": "417-877-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAVIS",
"first_name": "ERIC",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2007008411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.