Chiropractic Wellness Center of Goshen, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CHIROPRACTIC WELLNESS CENTER OF GOSHEN, PC

Practice address

401 E Madison St
Goshen, IN 46526-3431

Phone

(574) 533-7363

NPI assigned

Oct 10, 2006

Last updated

Aug 22, 2020By 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

Maxim I Ivanov, D.C.NPI 1669560280

Title

Owner

Phone

(574) 533-7363

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Maxim I Ivanov, D.C.

  • Chiropractor
  • Goshen, IN
  • NPI 1669560280
  NPD (past) Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174611792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E MADISON ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465263431",
            "telephone_number": "574-533-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E MADISON ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465263431",
            "telephone_number": "574-533-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC WELLNESS CENTER OF GOSHEN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IVANOV",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-533-7363",
        "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": []
}

• Change Architects LLP
• Douglas Allan Charlesworth
• Maritza E Chavez Stahly, LAT, ATC
• Casilda Cabral Chenier, PA
• Winfield Alfred Chester, MSW, LSW
• Janelle E Christensen, MSW
• Linda Christophel
• City of Goshen
• Jill D Claassen
• Isidro Clara Jr.

• Chiropractor in Goshen, IN
• Providers in Goshen, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.