MEDICARE: ADVANCED CHIROPRACTIC HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2000167943	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00491248	OTHER	MO	MISSOURI CORPORATE NO.
2	1386852127	OTHER	MO	TYPE 1 NPI
3	18104711	OTHER	MO	MISSOURI STATE TAX ID
4	29808015	OTHER	MO	BC BS INDIVIDUAL DR. NO.
5	2000167943	OTHER	MO	STATE LICENSE NO.
6	09803014	OTHER	MO	BC BS GROUP NO.
7	DE 870005	OTHER	MO	EMPLOYER NUMBER

General Provider Information

NPI Number	:	1578769345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CHIROPRACTIC HEALTH

Provider Business Mailing Address
First Line	:	1402 NW VIVION RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4555
Country	:	US
Telephone Number	:	816-746-9045
Fax Number	:	816-746-9032

Provider Business Practice Location Address
First Line	:	1402 NW VIVION RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4555
Country	:	US
Telephone Number	:	816-746-9045
Fax Number	:	816-746-9032

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS PATRICK MCNERNEY
Credential	:	DC
Telephone Number	:	816-746-9045

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1528152451 — DR. BRUCE JAMES DERR DDS
Practice Location Address:

1420 NW VIVION RD , STE.#107
KANSAS CITY, MO
64118-4555

Practice Phone: 816-505-0555
Practice Fax: 816-505-2662

1609965169 — JEFFREY DEAN SPENCER DC
Practice Location Address:

1414 NW VIVION RD
KANSAS CITY, MO
64118-4555

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1386852127 — DR. THOMAS PATRICK MCNERNEY D.C.
Practice Location Address:

1402 NW VIVION RD
KANSAS CITY, MO
64118-4555

Practice Phone: 816-746-9045
Practice Fax: 816-734-9035

1720245327 — SPENCER CHIROPRACTIC CLINIC, P.C.
Practice Location Address:

1414 NW VIVION RD
KANSAS CITY, MO
64118-4555

Practice Phone: 816-746-8300
Practice Fax:

1306070313 — DR. THOMAS PATRICK O'REILLY JR. D.C.
Practice Location Address:

1414 NW VIVION RD
KANSAS CITY, MO
64118-4555

Practice Phone: 816-746-8300
Practice Fax: 816-746-7958

1487084836 — JILL BOSWELL
Practice Location Address:

1460 NW VIVION RD
KANSAS CITY, MO
64118-4555

Practice Phone: 816-853-0946
Practice Fax: 816-396-8809

Directions to “ADVANCED CHIROPRACTIC HEALTH ” Practice Location

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