NPIMap

Organization Active NPI

Cardinal Wellness Services

Doing business as Performance Wellness South

  • Chiropractor
  • Indianapolis, IN
National Provider Identifier
1043507940
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CARDINAL WELLNESS SERVICES
Doing business as
Performance Wellness South
Practice address
3786 S East St
Indianapolis, IN 46227-1241
Phone
(317) 791-1511
NPI assigned
Jun 30, 2011
Last updated
Jun 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Authorized official

Name
Jacob Roberts
Title
Owner
Phone
(317) 791-1511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

3786 S East St
Indianapolis, IN 46227-1241

Mailing address

3786 S East St
Indianapolis, IN 46227-1241

Other names 1

  • Performance Wellness South Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cardinal Wellness Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1043507940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3786 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3786 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271241",
            "telephone_number": "317-791-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-791-1511"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Wellness South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.