Elevate Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHR0007247 Issued in CO

Legal business name

ELEVATE CHIROPRACTIC LLC

Practice address

901 E Harmony Rd
Fort Collins, CO 80525-4941

Phone

(970) 624-0424

NPI assigned

Feb 25, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Wallis, DCNPI 1205228467

Title

Owner

Phone

(970) 624-0424

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

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

• Daniel Wallis, DC

  • Chiropractor
  • Fort Collins, CO
  • NPI 1205228467
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1295127454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E HARMONY RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254941",
            "telephone_number": "970-624-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E HARMONY RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254941",
            "telephone_number": "970-624-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-624-0424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR0007247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.