Active NPI
Wellsprings Chiropractic
- Rehabilitation Chiropractor
- Gaithersburg, MD
National Provider Identifier
1245421007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 01987
- Legal business name
- WELLSPRINGS CHIROPRACTIC
- Practice address
- 937 Russell Ave Ste B
Gaithersburg, MD 20879-3280 - Phone
- (301) 519-1881
- Fax
- (301) 519-1131
- NPI assigned
- Aug 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kenneth John Fish, D.C.
- Title
- Clinic Director
- Phone
- (301) 519-1881
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 01987 | MD | Primary |
Addresses
Primary practice location
937 Russell Ave Ste B
Gaithersburg, MD 20879-3280
Mailing address
937 Russell Ave Ste B
Gaithersburg, MD 20879-3280
Phone (301) 519-1881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
937 Russell Ave
Ste B
Gaithersburg, MD 20879
Phone (301) 519-1881
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": "1186444800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212969600000",
"number": "1245421007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "937 RUSSELL AVE STE B",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793280",
"telephone_number": "301-519-1881",
"fax_number": "301-519-1131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "937 RUSSELL AVE STE B",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793280",
"telephone_number": "301-519-1881",
"fax_number": "301-519-1131"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLSPRINGS CHIROPRACTIC",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-07",
"last_updated": "2008-06-09",
"status": "A",
"authorized_official_last_name": "FISH",
"authorized_official_first_name": "KENNETH",
"authorized_official_middle_name": "JOHN",
"authorized_official_title_or_position": "CLINIC DIRECTOR",
"authorized_official_telephone_number": "301-519-1881",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Rehabilitation",
"state": "MD",
"license": "01987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.