NPIMap

Organization Active NPI

Wellness Center of Elkhorn City

  • Clinic/Center
  • Elkhorn City, KY
National Provider Identifier
1356628648
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WELLNESS CENTER OF ELKHORN CITY
Practice address
17401 Hwy 80E
Elkhorn City, KY 41522
Phone
(606) 754-3131
Fax
(606) 754-4554
NPI assigned
Nov 15, 2011
Last updated
Jan 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Authorized official

Name
Allen Ray Maynard, PACNPI 1134300932
Title
Owner
Phone
(606) 754-3131

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
Clinic/Center 261Q00000X KY Primary

Addresses

Primary practice location

17401 Hwy 80E
Elkhorn City, KY 41522

Mailing address

PO Box 1412
Elkhorn City, KY 41522-1412
Phone (606) 754-3131

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1356628648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1412",
            "city": "ELKHORN CITY",
            "state": "KY",
            "postal_code": "415221412",
            "telephone_number": "606-754-3131",
            "fax_number": "606-754-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17401 HWY 80E",
            "city": "ELKHORN CITY",
            "state": "KY",
            "postal_code": "41522",
            "telephone_number": "606-754-3131",
            "fax_number": "606-754-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS CENTER OF ELKHORN CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "MAYNARD",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-754-3131",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn City, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.