NPIMap

Organization Active NPI

Healthy Life Chiropractic and Wellness, LLC

  • Nutrition Chiropractor
  • O'Fallon, MO
National Provider Identifier
1053739235
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
2013024791 Issued in MO
Legal business name
HEALTHY LIFE CHIROPRACTIC AND WELLNESS, LLC
Practice address
1601 Bryan Rd
O Fallon, MO 63368-4815
Phone
(636) 474-2273
Fax
(636) 474-2272
NPI assigned
Apr 3, 2014
Last updated
Jul 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Authorized official

Name
Dr. Daniel Jablonski, D.C.NPI 1487086385
Title
Chiropractic Physician
Phone
(636) 474-2273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN1001X 2013024791 MO Primary

Addresses

Primary practice location

1601 Bryan Rd
O Fallon, MO 63368-4815

Mailing address

PO Box 620
Saint Albans, MO 63073-0620
Phone (636) 474-2273

Other names 1

  • Family Wellness & Nutrition, LLC Former legal business name

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, 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": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1053739235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 620",
            "city": "SAINT ALBANS",
            "state": "MO",
            "postal_code": "630730620",
            "telephone_number": "636-474-2273",
            "fax_number": "636-474-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRYAN RD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633684815",
            "telephone_number": "636-474-2273",
            "fax_number": "636-474-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIFE CHIROPRACTIC AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-03",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "JABLONSKI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "636-474-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "MO",
            "license": "2013024791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Wellness & Nutrition, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.