Organization Active NPI

Wellness Way Grand Rapids LLC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1013504026
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WELLNESS WAY GRAND RAPIDS LLC
Practice address
3682 29TH St SE Ste a
Grand Rapids, MI 49512-1808
Phone
(616) 734-6498
NPI assigned
Dec 23, 2020
Last updated
Dec 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Patrick Flynn, DCNPI 1366477341
Title
Owner
Phone
(920) 429-2844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

3682 29TH St SE Ste a
Grand Rapids, MI 49512-1808

Mailing address

3682 29TH St SE Ste a
Grand Rapids, MI 49512-1808
Phone (616) 734-6498

National Provider Directory

National Provider Directory

Locations

2525 W Mason St
Green Bay, WI 54303
Phone (920) 429-2844

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1013504026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3682 29TH ST SE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121808",
            "telephone_number": "616-734-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3682 29TH ST SE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121808",
            "telephone_number": "616-734-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS WAY GRAND RAPIDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-23",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-429-2844",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.