Organization Active NPI

Superstition Wellness Center PLLC

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1063780708
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SUPERSTITION WELLNESS CENTER PLLC
Practice address
1946 S Signal Butte Rd
Suite A105
Mesa, AZ 85209-2732
Phone
(480) 857-2098
Fax
(480) 963-7097
NPI assigned
Dec 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Dr. Ryan W Wade, D.C.
Title
Member
Phone
(480) 857-2098

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1946 S Signal Butte Rd
Suite A105
Mesa, AZ 85209-2732

Mailing address

1100 S Dobson Rd
Suite 112
Chandler, AZ 85286-6157
Phone (480) 857-2098

National Provider Directory

National Provider Directory

Locations

1946 S Signal Butte Rd
Ste A105
Mesa, AZ 85209
Phone (480) 857-2098

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": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1063780708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S DOBSON RD",
            "address_2": "SUITE 112",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866157",
            "telephone_number": "480-857-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1946 S SIGNAL BUTTE RD",
            "address_2": "SUITE A105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852092732",
            "telephone_number": "480-857-2098",
            "fax_number": "480-963-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERSTITION WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "480-857-2098",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.