Organization Active NPI

Superior Wellness LLC

  • Chiropractor
  • Sandy, UT
National Provider Identifier
1033826185
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SUPERIOR WELLNESS LLC
Practice address
8170 S Highland Dr Ste E4
Sandy, UT 84093-6465
Phone
(801) 942-4999
Fax
(801) 942-8816
NPI assigned
Oct 28, 2022
Last updated
Oct 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Authorized official

Name
Kali Krivinchuk, DCNPI 1548982473
Title
Owner
Phone
(218) 343-7173

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 Primary

Addresses

Primary practice location

8170 S Highland Dr Ste E4
Sandy, UT 84093-6465

Mailing address

8170 S Highland Dr Ste E4
Sandy, UT 84093-6465
Phone (801) 942-4999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221223000671 UT Part B Supplier - Clinic/Group Practice 8325418973 Receives reassigned benefits from 1 practitioner
Practice locations: Sandy, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1666915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1033826185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 S HIGHLAND DR STE E4",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936465",
            "telephone_number": "801-942-4999",
            "fax_number": "801-942-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 S HIGHLAND DR STE E4",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936465",
            "telephone_number": "801-942-4999",
            "fax_number": "801-942-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "KRIVINCHUK",
        "authorized_official_first_name": "KALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-343-7173",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.