NPIMap

Organization Active NPI

Wellness Concepts Clinic

  • Chiropractor
  • Springfield, MO
National Provider Identifier
1073805776
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2007008411 Issued in MO
Legal business name
WELLNESS CONCEPTS CLINIC
Practice address
1200 E Woodhurst Dr
Suite R300
Springfield, MO 65804-4261
Phone
(417) 877-1300
Fax
(417) 877-1335
NPI assigned
May 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Authorized official

Name
Jill Reavis-Aleman
Title
Acupuncturist
Phone
(417) 877-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 2007008411 MO Primary

Addresses

Primary practice location

1200 E Woodhurst Dr
Suite R300
Springfield, MO 65804-4261

Mailing address

1200 E Woodhurst Dr
Suite R300
Springfield, MO 65804-4261

Other identifiers 2

IdentifierTypeStateIssuer
2002030343OtherMOLICENSE
2010000775OtherMOLICENSE

National Provider Directory

National Provider Directory
Tax ID family
Wellness Concepts Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1073805776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E WOODHURST DR",
            "address_2": "SUITE R300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044261",
            "fax_number": "417-877-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E WOODHURST DR",
            "address_2": "SUITE R300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044261",
            "telephone_number": "417-877-1300",
            "fax_number": "417-877-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS CONCEPTS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "REAVIS-ALEMAN",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "417-877-1300"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007008411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2002030343",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2010000775",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.