Yensid Jr LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08001756A Issued in IN

Legal business name

YENSID JR LLC

Practice address

3027 Mishawaka Ave
South Bend, IN 46615-2347

Phone

(574) 259-9355

Fax

(574) 288-2737

NPI assigned

Jul 23, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Lisa A Meyers, DCNPI 1912905712

Title

Owner

Phone

(574) 259-9355

Specialties & licenses 1

Addresses

Other names 1

• Active Health and Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Ann Meyers, D.C.

  • Chiropractor
  • South Bend, IN
  • NPI 1912905712
  Medicare reassignment NPD Authorized official
• Matthew Blackmon, DC

  • Chiropractor
  • La Porte, IN
  • NPI 1073970521
  Medicare reassignment
• Patrick William Case, DC, FACO

  • Orthopedic Chiropractor
  • South Bend, IN
  • NPI 1487652277
  NPD (past)

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1295110989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3027 MISHAWAKA AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152347",
            "telephone_number": "574-259-9355",
            "fax_number": "574-288-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3027 MISHAWAKA AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152347",
            "telephone_number": "574-259-9355",
            "fax_number": "574-288-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YENSID JR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "MEYERS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-259-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001756A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ruth Anketell Yarger, LCSW
• Zuhair Habib Yaseen, MD
• Tiffany Lee Yates, LMFT
• Robin Marie Yazel, MSED
• Evan Yeider, RBT
• Sree Sushma Yenuga, RPT
• Jeffrey D. Yergler, MD
• Michael A Yergler, M.D.
• Charles Yi
• Hannah Grace Yoder, CNM

• Chiropractor in South Bend, IN
• Providers in South Bend, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.