Integrated Chiropractic Wellness, PLLC

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

10555 Issued in TX

Legal business name

INTEGRATED CHIROPRACTIC WELLNESS, PLLC

Practice address

1600 W 38TH St
Suite 412
Austin, TX 78731-6400

Phone

(512) 970-8883

NPI assigned

Apr 3, 2007

Last updated

Jan 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kristen K Ude, D.C.NPI 1720087331

Title

Owner

Phone

(512) 970-8883

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristen Katherine Ude, D.C.

  • Nutrition Chiropractor
  • Austin, TX
  • NPI 1720087331
  Medicare reassignment NPD Authorized official
• Patrick Clark, DC

  • Chiropractor
  • Austin, TX
  • NPI 1558301242
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1144342064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST",
            "address_2": "SUITE 412",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316400",
            "telephone_number": "512-970-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST",
            "address_2": "SUITE 412",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316400",
            "telephone_number": "512-970-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CHIROPRACTIC WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "UDE",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-970-8883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "TX",
            "license": "10555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "0012PN",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nutrition Chiropractor in Austin, TX
• Providers in Austin, TX by specialty
• Nutrition Chiropractor in Texas

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