Organization Active NPI

Wilson Chiropractic Center, Inc.

  • Chiropractor
  • Opelousas, LA
National Provider Identifier
1104084748
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
188 Issued in LA
Legal business name
WILSON CHIROPRACTIC CENTER, INC.
Practice address
215 S Market St
Opelousas, LA 70570-5139
Phone
(337) 948-1856
Fax
(337) 948-1262
NPI assigned
May 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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

Authorized official

Name
Dr. Joe H WilsonNPI 1851514400
Title
President
Phone
(337) 948-1856

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 188 LA Primary

Addresses

Primary practice location

215 S Market St
Opelousas, LA 70570-5139

Mailing address

215 S Market St
Opelousas, LA 70570-5139
Phone (337) 948-1856

Other identifiers 2

IdentifierTypeStateIssuer
1951358MedicaidLA
20088OtherLABLUE CROSS BLUE SHIELD OF LA.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080819000904 LA Part B Supplier - Clinic/Group Practice 0648345025 Receives reassigned benefits from 1 practitioner
Practice locations: Opelousas, LA

National Provider Directory

National Provider Directory

Locations

215 S Market St
Opelousas, LA 70570
Phone (337) 948-1856

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": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1104084748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S MARKET ST",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705705139",
            "telephone_number": "337-948-1856",
            "fax_number": "337-948-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S MARKET ST",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705705139",
            "telephone_number": "337-948-1856",
            "fax_number": "337-948-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON CHIROPRACTIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-948-1856",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1951358",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF LA.",
            "identifier": "20088",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelousas, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.