NPIMap

Organization Active NPI

W Chiropractic Incorporated

  • Chiropractor
  • Missoula, MT
National Provider Identifier
1346399896
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0826 Issued in MT
Legal business name
W CHIROPRACTIC INCORPORATED
Practice address
2801 Great Northern Loop
Missoula, MT 59808-1678
Phone
(406) 549-9100
Fax
(406) 549-9151
NPI assigned
Jan 10, 2007
Last updated
Nov 14, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Dr. Mark A Wilson, D.C.NPI 1700950771
Title
Owner
Phone
(406) 549-9100

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
Chiropractor 111N00000X 0826 MT Primary

Addresses

Primary practice location

2801 Great Northern Loop
Missoula, MT 59808-1678

Mailing address

2801 Great Northern Loop
Missoula, MT 59808-1745
Phone (406) 549-9100

Other identifiers 1

IdentifierTypeStateIssuer
0164169MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000370 MT Part B Supplier - Clinic/Group Practice 5496647661 Receives reassigned benefits from 1 practitioner
Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Locations

2300 Great Northern Ave
Missoula, MT 59808
Phone (406) 549-9100

2801 Great Northern Loop
Missoula, MT 59808
Phone (406) 549-9100

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1346399896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 GREAT NORTHERN LOOP",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081745",
            "telephone_number": "406-549-9100",
            "fax_number": "406-549-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 GREAT NORTHERN LOOP",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081678",
            "telephone_number": "406-549-9100",
            "fax_number": "406-549-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W CHIROPRACTIC INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-549-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "0826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164169",
            "state": "MT"
        }
    ],
    "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 Nov 14, 2007; 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.