NPIMap

Organization Active NPI

Upstat Professional Services, LLC

Doing business as Living Wellness Chiropractic of Columbia

  • Chiropractor
  • Columbia, MD
National Provider Identifier
1346534070
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S02029 Issued in MD
Legal business name
UPSTAT PROFESSIONAL SERVICES, LLC
Doing business as
Living Wellness Chiropractic of Columbia
Practice address
6420 Dobbin Rd
Suite a
Columbia, MD 21045-4749
Phone
(443) 524-6600
Fax
(443) 524-6608
NPI assigned
May 28, 2011
Last updated
Feb 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Authorized official

Name
Dr. Eric Ross Huntington, DCNPI 1538148275
Title
President
Phone
(443) 992-3685

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X S02029 MD Primary

Addresses

Primary practice location

6420 Dobbin Rd
Suite a
Columbia, MD 21045-4749

Mailing address

220 W Cold Spring LN
Baltimore, MD 21210-2802
Phone (443) 524-6600

Other names 1

  • Living Wellness Chiropractic of Columbia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120221000553 MD Part B Supplier - Clinic/Group Practice 1951569052 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, MD

National Provider Directory

National Provider Directory

Locations

6420 Dobbin Rd
Ste A
Columbia, MD 21045
Phone (443) 319-5770

6410 Dobbin Rd
Ste A
Columbia, MD 21045
Phone (443) 319-5770

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1306540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1346534070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W COLD SPRING LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102802",
            "telephone_number": "443-524-6600",
            "fax_number": "443-524-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 DOBBIN RD",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454749",
            "telephone_number": "443-524-6600",
            "fax_number": "443-524-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTAT PROFESSIONAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-28",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "HUNTINGTON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-992-3685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S02029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Wellness Chiropractic of Columbia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.