IMAC Regeneration Center of St. Louis – Sports Medicine (Family Medicine) Physician, NPI 1306203096

IMAC Regeneration Center of St. Louis is a healthcare provider. based in Saint peters, Missouri. specializing in Sports Medicine (Family Medicine) Physician. The NPI Number for IMAC Regeneration Center of St. Louis is 1306203096

Main info

Organization
Name
IMAC Regeneration Center of St. Louis
NPI
1306203096
Phone
(314) 200-4955
Address
263 Salt Lick Rd
Authorized Official
THERESA LUECKE HUMAN RESOURCES
Enumeration Date
26 January 2016
Last Update Date
19 August 2020
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness80
Years active:10State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for IMAC Regeneration Center of St. Louis

  • 263 Salt Lick Rd

    Saint Peters, MO 633765974

    Phone: (314) 200-4955

    Fax: (314) 682-6001

    Type: Location

  • James Sanders Boulevard, Paducah, McCracken County, Kentucky, 42001, United States

    SUITE A

    PADUCAH, KY 420018401

    Phone: (314) 200-4955

    Type: Mailing

  • 13353, Olive Boulevard, Chesterfield, Saint Louis County, Missouri, 63017, United States

    CHESTERFIELD, MO 630173108

    Phone: (314) 200-4955

    Fax: (314) 682-6001

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63376)

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Reviews

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Frequently asked questions

How is IMAC Regeneration Center of St. Louis identified in CMS data?
CMS-hosted NPPES data lists IMAC Regeneration Center of St. Louis with NPI 1306203096.
Can I rely on IMAC Regeneration Center of St. Louis being an active provider?
As of the registry snapshot, IMAC Regeneration Center of St. Louis is marked active.
What healthcare role does IMAC Regeneration Center of St. Louis hold?
Scheduling teams often label IMAC Regeneration Center of St. Louis under Sports Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
What area does IMAC Regeneration Center of St. Louis serve?
IMAC Regeneration Center of St. Louis's listing highlights Saint Peters, Missouri; more addresses can appear in NPPES.
Is the information about IMAC Regeneration Center of St. Louis up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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