IMAC REGENERATION CENTER OF ST. LOUIS
NPI 1306203096
Family Medicine - Sports Medicine in Chesterfield, MO

Q: What is Integrated Medicine And Chiropractic Regeneration Center O's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Active since January 26, 2016

13353 OLIVE BLVD, CHESTERFIELD, MO 63017(314) 200-4955(314) 682-6001 Get Directions Write a Review

NPPES record last updated: August 19, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 19, 2020, Mar 10, 2020, Feb 29, 2016 and 1 more (4 updates tracked since 2016).

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About Imac Regeneration Center Of St. Louis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMAC REGENERATION CENTER OF ST. LOUIS (NPI 1306203096) is a healthcare organization registered as a sports medicine in Chesterfield, Missouri and active in the NPI registry since January 2016. The organization maintains a secondary practice location in Saint Peters and lists Theresa Luecke, Human Resources, as its authorized official.

NPPES Registry Identity

NPI1306203096

Entity TypeOrganization

Primary Taxonomy207QS0010X

Legal Business NameINTEGRATED MEDICINE AND CHIROPRACTIC REGENERATION CENTER O

Location Address13353 OLIVE BLVDChesterfield, MO 63017-3108

Mailing Address2725 James Sanders Blvd, Suite APaducah, KY 42001-8401 · (314) 200-4955

Phone(314) 200-4955

Fax(314) 682-6001

Organization SubpartNo

Authorized OfficialTheresa LueckeHuman Resources · (270) 554-5114

Enumeration DateJanuary 26, 2016

Last NPPES UpdateAugust 19, 20204 updates tracked since enumeration

NPPES CertifiedAugust 19, 2020

✔ NPI 1306203096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 14

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Also ListedChiropractorTaxonomy 111N00000X

Also ListedChiropractor · OrthopedicTaxonomy 111NX0800X

Also ListedAnesthesiologyTaxonomy 207L00000X

Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X

Also ListedPain Medicine · Pain MedicineTaxonomy 208VP0000X

Also ListedPhysical TherapistTaxonomy 225100000X

Also ListedMassage TherapistTaxonomy 225700000X

Also ListedOccupational TherapistTaxonomy 225X00000X

Also ListedRespiratory Therapist, CertifiedTaxonomy 227800000X

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X

Also ListedNurse Practitioner · Occupational HealthTaxonomy 363LX0106X

13353 OLIVE BLVD, Chesterfield, MO 63017

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Other Names 1

Other NameImac Regeneration Center Of St. Louis

Secondary Practice Location 1

Location 1263 Salt Lick RdSaint Peters, MO 63376-5974 · Phone (314) 200-4955 · Fax (314) 682-6001

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAQUEL K RUSSO PA-C

Physician Assistant