Mountain State Wellness, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MOUNTAIN STATE WELLNESS, PLLC

Practice address

965 Hartman Run Rd
Suite 1101
Morgantown, WV 26505-7700

Phone

(304) 292-7740

NPI assigned

Jan 7, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Lucas C Watterson, D.C.NPI 1437103603

Title

Member/Direct Owner

Phone

(304) 292-7740

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lucas Chadd Watterson, DC

  • Chiropractor
  • Morgantown, WV
  • NPI 1437103603
  Medicare reassignment Care Compare group NPD Authorized official
• Amy Janel Watterson, DC

  • Chiropractor
  • Morgantown, WV
  • NPI 1588618227
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1023348448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 HARTMAN RUN RD",
            "address_2": "SUITE 1101",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265057700",
            "telephone_number": "304-292-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 HARTMAN RUN RD",
            "address_2": "SUITE 1101",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265057700",
            "telephone_number": "304-292-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATE WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-07",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "WATTERSON",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEMBER/DIRECT OWNER",
        "authorized_official_telephone_number": "304-292-7740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountain Laurel Wellness LLC
• Mountain Ridge Physical Therapy LLC
• Mountain State Mobility
• Mountain State Sleep Center, Inc
• Mountain State Spinal Care
• Mountain Valley LLC
• Mountaineer Counseling
• Mountaineer Home Medical, LLC
• Mountaineer Orthodontics, PLLC
• Mountaineer Orthopedic Specialists, LLC

• Chiropractor in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Chiropractor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.