Organization Active NPI

Radiant Chiropractic and Wellness

  • Chiropractor
  • Missoula, MT
National Provider Identifier
1205547437
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
RADIANT CHIROPRACTIC AND WELLNESS
Practice address
2330 S Higgins Ave
Missoula, MT 59801-6923
Phone
(608) 438-4448
NPI assigned
Dec 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Authorized official

Name
Emily L Diaz, DCNPI 1871228965
Title
Owner
Phone
(608) 438-4448

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

2330 S Higgins Ave
Missoula, MT 59801-6923

Mailing address

2220 Tower St
Missoula, MT 59804-6379
Phone (608) 438-4448

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230922003200 MT Part B Supplier - Clinic/Group Practice 7214381334 Receives reassigned benefits from 1 practitioner
Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Locations

2330 S Higgins Ave
Missoula, MT 59801
Phone (406) 241-0233

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": "1670457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1205547437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 TOWER ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598046379",
            "telephone_number": "608-438-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S HIGGINS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016923",
            "telephone_number": "608-438-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT CHIROPRACTIC AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-08",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-438-4448",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.