Integrated Health and Wellness Center Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INTEGRATED HEALTH AND WELLNESS CENTER INC

Practice address

22 W Colt Square Dr
Fayetteville, AR 72703-2813

Phone

(479) 582-5900

Fax

(479) 582-0569

NPI assigned

Aug 9, 2021

Organization subpart

No

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

Authorized official

Name

Lucas J Van Der Merwe

Title

Owner

Phone

(479) 582-5900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1013681444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 W COLT SQUARE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032813",
            "telephone_number": "479-582-5900",
            "fax_number": "479-582-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W COLT SQUARE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032813",
            "telephone_number": "479-582-5900",
            "fax_number": "479-582-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH AND WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "VAN DER MERWE",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-582-5900"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.