Organization Active NPI

California Chiropractic Wellness Corporation

  • Chiropractor
  • Rocklin, CA
National Provider Identifier
1194079194
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-31678 Issued in CA
Legal business name
CALIFORNIA CHIROPRACTIC WELLNESS CORPORATION
Practice address
6839 Five Star Blvd
Suite F
Rocklin, CA 95677
Phone
(408) 960-4236
NPI assigned
Oct 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Authorized official

Name
Dr. Timothy Alan Smith, D.C.
Title
Chief Executive Officer
Phone
(408) 960-4236

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC-31678 CA Primary

Addresses

Primary practice location

6839 Five Star Blvd
Suite F
Rocklin, CA 95677

Mailing address

6839 Five Star Blvd
Suite F
Rocklin, CA 95677
Phone (408) 960-4236

Other names 1

  • New Life Chiropractic Doing business as

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": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1194079194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6839 FIVE STAR BLVD",
            "address_2": "SUITE F",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "95677",
            "telephone_number": "408-960-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6839 FIVE STAR BLVD",
            "address_2": "SUITE F",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "95677",
            "telephone_number": "408-960-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA CHIROPRACTIC WELLNESS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "408-960-4236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-31678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocklin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.