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LAKE ST. LOUIS CHIROPRACTIC
NPI 1508125303
Chiropractor in O Fallon, MO

Active since May 14, 2012
2161 W TERRA LN, O FALLON, MO 63366(636) 887-9003(888) 528-5527 Get Directions Write a Review

NPPES record last updated: May 14, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lake St. Louis Chiropractic NPPES

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

LAKE ST. LOUIS CHIROPRACTIC (NPI 1508125303) is a healthcare organization registered as a chiropractor in O Fallon, Missouri and active in the NPI registry since May 2012. The organization lists Kristin E. Gaines-porlier, Owner/doctor, as its authorized official.

NPPES Registry Identity

NPI1508125303
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameDYNAMIC LIFE CHIROPRACTIC, LLC
Location Address2161 W TERRA LNO Fallon, MO 63366-2366
Mailing Address2161 W Terra LnO Fallon, MO 63366-2366 · (636) 887-9003 · Fax (888) 528-5527
Phone(636) 887-9003
Fax(888) 528-5527
Organization SubpartNo
Authorized OfficialKristin E. Gaines-porlierOwner/doctor · (618) 213-6886
Enumeration DateMay 14, 2012
✔ NPI 1508125303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition
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.
2161 W TERRA LN, O Fallon, MO 63366
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Other Names 1

Doing Business AsLake St. Louis Chiropractic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lake St. Louis Chiropractic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Lake St. Louis Chiropractic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kristin Gaines-Porlier, D.C.
Chiropractic
NPI 1902114986
2161 W TERRA LN
O Fallon, MO 63366
(636) 887-3400
✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dynamic Life Chiropractic, LLC's NPI number?

The NPI number for Dynamic Life Chiropractic, LLC is 1508125303. It was assigned to this organization in the NPPES registry on May 14, 2012. The provider is doing business as Lake St. Louis Chiropractic.

Where is Dynamic Life Chiropractic, LLC located?

Dynamic Life Chiropractic, LLC is located at 2161 W Terra Ln, O Fallon, MO 63366. The listed phone number is (636) 887-9003.

What is Dynamic Life Chiropractic, LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Dynamic Life Chiropractic, LLC enrolled in Medicare?

Yes. Dynamic Life Chiropractic, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dynamic Life Chiropractic, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Dynamic Life Chiropractic, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Dynamic Life Chiropractic, LLC was last updated on May 14, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.