Waters Edge Chiropractic and Wellness Center Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1047 Issued in MT

Legal business name

WATERS EDGE CHIROPRACTIC AND WELLNESS CENTER INC

Practice address

1831 S 3Rd St W Ste 201
Missoula, MT 59801-2454

Phone

(406) 543-1955

Fax

(406) 543-1506

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Jeanie A Tripp

Title

Office Coordinator

Phone

(406) 543-1955

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MT

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.

• Shane Albert Cutting, D.C.

  • Chiropractor
  • Missoula, MT
  • NPI 1871546556
  Medicare reassignment NPD
• Jarrod Adam Fancher, DC

  • Chiropractor
  • Missoula, MT
  • NPI 1831380484
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1164467486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 SOUTH 3RD ST WEST",
            "address_2": "STE 201",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012454",
            "telephone_number": "406-543-1955",
            "fax_number": "406-543-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 S 3RD ST W STE 201",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012454",
            "telephone_number": "406-543-1955",
            "fax_number": "406-543-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERS EDGE CHIROPRACTIC AND WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "JEANIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "406-543-1955"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "1047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO MEDICAID #",
            "identifier": "807199700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1871546556",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166260",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "000040923",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166270",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James David Washburn, LCSW, ACSW, MHP
• Mark Baker Washburn, LCPC
• Jacques La Cree Washignton, BT
• Lauren Waski
• Watercourse, PLLC
• Anastasia Waters, LMT
• Jeff Waters
• Laura Wathen, LCSW
• Lindsay Crandall Watkins, RD, IBCLC
• Duncan Watley, MD

• Chiropractor in Missoula, MT
• Providers in Missoula, MT by specialty
• Chiropractor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.