NPIMap

Organization Active NPI

Wellness Lake County Chiropractic

  • Chiropractor
  • Painesville, OH
National Provider Identifier
1093104465
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2653 Issued in OH
Legal business name
WELLNESS LAKE COUNTY CHIROPRACTIC
Practice address
1640 Mentor Avenue
Painesville, OH 44077
Phone
(440) 478-9325
NPI assigned
Jan 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Authorized official

Name
Dr. Brian J Morris, D.C.NPI 1598799371
Title
Owner
Phone
(440) 478-9325

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 2653 OH Primary

Addresses

Primary practice location

1640 Mentor Avenue
Painesville, OH 44077

Mailing address

1640 Mentor Ave
Painesville, OH 44077-1707
Phone (440) 478-9325

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151203001846 OH Part B Supplier - Clinic/Group Practice 4486954047 Receives reassigned benefits from 4 practitioners
Practice locations: Painesville, OH

National Provider Directory

National Provider Directory

Locations

1640 Mentor Ave
Painesville, OH 44077
Phone (440) 639-9171

Practitioners & affiliated clinicians

Practitioners 10

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": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449532800000",
    "number": "1093104465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 MENTOR AVE",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440771707",
            "telephone_number": "440-478-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 MENTOR AVENUE",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "44077",
            "telephone_number": "440-478-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS LAKE COUNTY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-12-08",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-478-9325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.