Individual provider Active NPI

Robert Coty Spraggs, DC

  • Chiropractor
  • Lake Saint Louis, MO
National Provider Identifier
1992467864
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2021016087 Issued in MO
Practice address
3445 Technology Dr
Lake Saint Louis, MO 63367-2599
Phone
(636) 466-9644
NPI assigned
Oct 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2021016087 MO Primary

Addresses

Primary practice location

3445 Technology Dr
Lake Saint Louis, MO 63367-2599

Mailing address

3445 Technology Dr
Lake Saint Louis, MO 63367-2599
Phone (636) 466-9644

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

LicenseStateTypeSpecialty
2021016087MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Adjusted Life Chiropractic LLC Chiropractor CurrentSince Nov 12, 2021 Accepting new patients

Locations

3445 Technology Dr
Lake St Louis, MO 63367
Phone (636) 466-9644

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1992467864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 TECHNOLOGY DR",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633672599",
            "telephone_number": "636-466-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 TECHNOLOGY DR",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633672599",
            "telephone_number": "636-466-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAGGS",
        "first_name": "ROBERT",
        "middle_name": "COTY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2021016087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.