Organization Active NPI

Wellcare Chiropractic, Inc.

  • Chiropractor
  • Hershey, PA
National Provider Identifier
1023071628
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WELLCARE CHIROPRACTIC, INC.
Practice address
475 W Governor Rd
Suite 3
Hershey, PA 17033-2217
Phone
(717) 533-0881
Fax
(717) 533-2155
NPI assigned
Apr 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lynda Crawford
Title
Manager of Operations
Phone
(717) 533-0881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X PA Primary

Addresses

Primary practice location

475 W Governor Rd
Suite 3
Hershey, PA 17033-2217

Mailing address

475 W Governor Rd
Suite 3
Hershey, PA 17033-2217
Phone (717) 533-0881

Other identifiers 3

IdentifierTypeStateIssuer
1639143068OtherPAROBIN MCCONNELL NPI
1144295601OtherPADANIEL KOVAL NPI
1558336859OtherPAPENNY KOVAL NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040826000541 PA Part B Supplier - Clinic/Group Practice 0840265674 Receives reassigned benefits from 2 practitioners
Practice locations: Hershey, PA

National Provider Directory

National Provider Directory

Locations

1249 Cocoa Ave
Hershey, PA 17033
Phone (717) 298-1268

475 W Governor Rd
Ste 3
Hershey, PA 17033
Phone (717) 533-0881

Practitioners & affiliated clinicians

Practitioners 12

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": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023071628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 W GOVERNOR RD",
            "address_2": "SUITE 3",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332217",
            "telephone_number": "717-533-0881",
            "fax_number": "717-533-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W GOVERNOR RD",
            "address_2": "SUITE 3",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332217",
            "telephone_number": "717-533-0881",
            "fax_number": "717-533-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "MANAGER OF OPERATIONS",
        "authorized_official_telephone_number": "717-533-0881"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROBIN MCCONNELL NPI",
            "identifier": "1639143068",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DANIEL KOVAL NPI",
            "identifier": "1144295601",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNY KOVAL NPI",
            "identifier": "1558336859",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.