NPIMap

Organization Active NPI

Bennett Chiropractic Wellness Center, LLC

  • Chiropractor
  • Elkhart, IN
National Provider Identifier
1033640586
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002949A Issued in IN
Legal business name
BENNETT CHIROPRACTIC WELLNESS CENTER, LLC
Practice address
1178 Fremont CT
Elkhart, IN 46516-9321
Phone
(574) 238-6199
NPI assigned
Mar 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Authorized official

Name
Matthew BennettNPI 1578096996
Title
Chief Executive Officer
Phone
(574) 238-6199

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 08002949A IN Primary

Addresses

Primary practice location

1178 Fremont CT
Elkhart, IN 46516-9321

Mailing address

1618 Weaver Woods Dr
Goshen, IN 46526-8142
Phone (574) 238-6199

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1033640586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 WEAVER WOODS DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465268142",
            "telephone_number": "574-238-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 FREMONT CT",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169321",
            "telephone_number": "574-238-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNETT CHIROPRACTIC WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "574-238-6199"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002949A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.