KINESIOLOGY CENTER OF GREATER ST LOUIS INC (NPI# 1649296583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649296583 |
| Entity Type | Organization |
| Organization Name | KINESIOLOGY CENTER OF GREATER ST LOUIS INC |
| Practice Address |
608 No Mcknight Rd St Louis MO 63132-4911 |
| Mailing Address |
8229 Clayton Rd Suite 204 Saint Louis MO 63117-1155 |
| Practice Telephone | 3149915655 |
| Practice Fax Number | 3149914872 |
| Mailing Telephone | 3149915655 |
| Mailing Fax Number | 3145325080 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2014-03-27 |
| Authorized Official Name | KATHARINE M CONABLE (VICE PRESIDENT) |
| Authorized Official Telephone | 3149915655 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 3930 | MO | Chiropractic Providers |
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| EMPIRE BLUE CROSS | 10146X | 01 | |
| HEALTHLINK | 179148 | 01 | |
| AETNA | 4582036 | 01 | |
| EMPIRE BLUE CROSS | 10315X | 01 | |
| RR MEDICARE GROUP PIN | 990001765 | 01 | |
| HEALTH ALLIANCE | 084723 | 01 | |
| AETNA | 4327678 | 01 | |
| BLUE CROSS BS OF MO | 7412 | 01 | |
| HEALTHLINK | 178246 | 01 | |
| RAILROAD MEDICARE | 350045267 | 01 | |
| GROUP HEALTH PLAN | 57883 | 01 | |
| MISSOURI LICENSE | 3930 | 01 |
| Street Address |
608 NO MCKNIGHT RD |
| City | ST LOUIS |
| State | MO |
| Zip Code | 63132-4911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811505712 | Takesha Sharice Gates | Home Health | 1614 Page Industrial Blvd, Apt A, Overland, MO 63132 | 2020-07-16 |
| 1962042440 | Fourroux Prosthetics, Inc | Prosthetic/Orthotic Supplier | 9665 Page Avenue, Overland, MO 63132 | 2020-01-13 |
| 1538715354 | Katharine M Rug | Dietitian, Registered | 1177 North Warson Rd, St. Louis, MO 63132 | 2019-08-16 |
| 1194295964 | Rivka Goldenhersh, D.m.d., LLC | Dentist | 620a N Mcknight Rd Ste 2a, Saint Louis, MO 63132 | 2018-12-04 |
| 1265902829 | Danica Dupree | Behavior Technician | 1322 Baur Blvd, Olivette, MO 63132 | 2018-11-27 |
| 1598277766 | Carol Lynne Oliver | Counselor | 10176 Corporate Square Dr Ste Office13, Saint Louis, MO 63132 | 2017-10-27 |
| 1972053783 | Rebecca Newel | Counselor | 9378 Olive Blvd Ste 312, Olivette, MO 63132 | 2016-10-05 |
| 1942654074 | Felicia Harris | Durable Medical Equipment & Medical Supplies | 10096 Page Blvd, St Loius, MO 63132 | 2016-04-14 |
| 1518328087 | Joseph Franklin Doney | Counselor | 10101 Woodfield Lane St., Suite 100, St. Louis, MO 63132 | 2016-03-11 |
| 1528428141 | Visiting Personal Care Attendants | Nursing Care | 9270 Olive Blvd Ste A, Olivette, MO 63132 | 2016-02-24 |
| Find all providers in zip 63132 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659582104 | John Michael Bott | Chiropractor | 8787 Big Bend, St Louis, MO 63119 | 2007-05-25 |
| 1083736243 | Gary Jean Jameson | Chiropractor | 2901 S Brentwood Blvd, St Louis, MO 63144 | 2007-04-06 |
| 1720108004 | David Gerard Hartmann | Chiropractor | 5226 S Lindbergh Blvd, St Louis, MO 63126-3519 | 2007-03-30 |
| 1912038308 | Richard Wayne Cranwell | Chiropractor | 11705 Gravois Road, St Louis, MO 63127 | 2007-03-08 |
| 1043340482 | Paulette Chiropractic and Acupuncture | Chiropractor | 6341 Clayton Road, St Louis, MO 63117 | 2007-03-06 |
| 1720122401 | Devereux Chiropractic & Acupuncture LLC | Chiropractor | 4500 Telegraph, Suite 104, St Louis, MO 63129 | 2007-02-16 |
| 1942352109 | Mary Patricia Ganley | Chiropractor | 3470 Hampton Ave, Suite 102, St Louis, MO 63139-1936 | 2007-01-17 |
| 1215089867 | Keith D Berger | Chiropractor | 8135 Delmar Blvd, St Louis, MO 63130-3729 | 2007-01-16 |
| 1932266509 | David Kurt Wipperman | Chiropractor | 11639 Studt Avenue, St Louis, MO 63141-7015 | 2007-01-03 |
| 1144398215 | Walter J Foland Jr. | Chiropractor | 4582 Telegraph Road, St Louis, MO 63129-3318 | 2006-11-30 |
| Find all providers in ST LOUIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.