Organization Active NPI

NLC Rehab and Wellness Inc

  • Chiropractor
  • Flower Mound, TX
National Provider Identifier
1114250792
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NLC REHAB AND WELLNESS INC
Practice address
2628 Long Prairie Rd
#105
Flower Mound, TX 75022-4839
Phone
(972) 899-8002
NPI assigned
Sep 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Authorized official

Name
Mr. Peter Gonyeau, D.C.NPI 1679631451
Title
President
Phone
(972) 899-8002

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 Primary

Addresses

Primary practice location

2628 Long Prairie Rd
#105
Flower Mound, TX 75022-4839

Mailing address

2628 Long Prairie Rd
#105
Flower Mound, TX 75022-4839
Phone (972) 899-8002

Other names 1

  • New Life Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091013000276 TX Part B Supplier - Clinic/Group Practice 8921144502 Receives reassigned benefits from 1 practitioner
Practice locations: Flower Mound, TX

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1114250792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2628 LONG PRAIRIE RD",
            "address_2": "#105",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224839",
            "telephone_number": "972-899-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 LONG PRAIRIE RD",
            "address_2": "#105",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224839",
            "telephone_number": "972-899-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NLC REHAB AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "GONYEAU",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-899-8002",
        "authorized_official_name_prefix": "Mr.",
        "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": [
        {
            "organization_name": "New Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.