Dimitrios M Theoharidis, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

006774 Issued in MO

Practice address

601 S State Route 291 Ste B
Liberty, MO 64068-1958

Phone

(816) 429-6598

Fax

(816) 429-8471

NPI assigned

Oct 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Chiropractic Healthcare Plus, PC

  • Chiropractor
  • Liberty, MO
  • NPI 1790862654
  Medicare reassignment NPD Authorized official
• Ankle and Foot Centers of Missouri P.C.

  • Foot & Ankle Surgery Podiatrist
  • Gladstone, MO
  • NPI 1790714491
  NPD (past)
• GVC Chiropractic of Independence, LLC

  • Chiropractor
  • Independence, MO
  • NPI 1629771969
  NPD (past)
• Schumacher Chiropractic LLC

  • Chiropractor
  • Independence, MO
  • NPI 1538029681
  NPD (past)

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1982797262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S STATE ROUTE 291 STE B",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681958",
            "telephone_number": "816-429-6598",
            "fax_number": "816-429-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S STATE ROUTE 291 STE B",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681958",
            "telephone_number": "816-429-6598",
            "fax_number": "816-429-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOHARIDIS",
        "first_name": "DIMITRIOS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-01",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010154",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Family Doctors Office PC
• The Liberty Clinic, Inc.
• The Urgency Room, LLC
• Clayton Lewis Theleman, M.D.
• Andria Mia Theoharidis, D.C.
• Theresa R Hubbard LLC
• Mary Juanita Thibodeaux, LCSW
• Tamra Thole, RD, LD
• Thomas C. Thomas
• Leslie D Thomas, M.D.

• Chiropractor in Liberty, MO
• Providers in Liberty, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.