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Deactivated NPI 1124147806 Deactivated / Inactive NPI Male Practitioner

Dr. Jerry A Carpenter , DC

Chiropractor • Ballwin, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jerry Carpenter has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 27, 2007
NPI Deactivation Date October 09, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Jerry Carpenter, DC was a registered Chiropractor practicing in Ballwin, MO. Throughout an active medical career spanning 18 years, Dr. Carpenter provided care at the practice location at 910 KEHRS MILL RD until profile deactivation on 2025-10-09.

Practice Location & Contact Primary Location

Practice Address

910 Kehrs Mill Rd
Suite 102

Ballwin, MO 63011

Telephone 6363911611
Fax 6363915856
Associated Practice Facility / Clinic
🏢 Sigsco, Inc. Facility NPI 1760595458

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Ballwin, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 21.8 Yrs
State Avg: 20.4 Yrs
Regional Practice Density
40 Specialists

Practicing in Ballwin, MO (2674 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License MO 4902

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 09, 2025

Record deactivated on October 09, 2025

NPI Profile Active May 21, 2008

NPI status registered as active in NPPES database

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Updated Practice Location May 21, 2008

Registered at 910 KEHRS MILL RD, SUITE 102, BALLWIN, MO 63011 (Tel: 6363911611)

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Updated Business Mailing Address May 21, 2008

Registered at 910 KEHRS MILL RD, SUITE 102, BALLWIN, MO 63011 (Tel: 6363911611)

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Provider Name / Credentials Updated May 21, 2008

Recorded as JERRY CARPENTER, DC

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 21, 2008

Chiropractor (License #4902 in MO)

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Initial NPI Registration & Enumeration March 27, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124147806
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 27, 2007
Last Update: May 21, 2008
Deactivation Date: October 09, 2025

Mailing Address

910 Kehrs Mill Rd, Suite 102

Ballwin, MO 63011

Phone: 6363911611

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.