NPIMap

Organization Active NPI

Synergistic Wellness Solutions LLC

  • Chiropractor
  • Glendale, AZ
National Provider Identifier
1366478794
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7451 Issued in AZ
Legal business name
SYNERGISTIC WELLNESS SOLUTIONS LLC
Practice address
7200 W Bell Rd
Suite G-104
Glendale, AZ 85308-8529
Phone
(623) 878-3100
Fax
(623) 878-2932
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark David Feller, D.C.
Title
Chiropractor/Owner
Phone
(623) 878-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 7451 AZ Primary

Addresses

Primary practice location

7200 W Bell Rd
Suite G-104
Glendale, AZ 85308-8529

Mailing address

7200 W Bell Rd
Suite G-104
Glendale, AZ 85308-8529
Phone (623) 878-3100

Other identifiers 1

IdentifierTypeStateIssuer
AZ0158930OtherAZTEMPORARY BC/BS PROVIDER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366478794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 W BELL RD",
            "address_2": "SUITE G-104",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088529",
            "telephone_number": "623-878-3100",
            "fax_number": "623-878-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 W BELL RD",
            "address_2": "SUITE G-104",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088529",
            "telephone_number": "623-878-3100",
            "fax_number": "623-878-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGISTIC WELLNESS SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FELLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "623-878-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMPORARY BC/BS PROVIDER",
            "identifier": "AZ0158930",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.