Elemental Wellness & Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1344 Issued in ID

Legal business name

ELEMENTAL WELLNESS & CHIROPRACTIC

Doing business as

Ewc

Practice address

343 E Main St
Weiser, ID 83672-2515

Phone

(208) 414-3333

NPI assigned

Jan 11, 2012

Last updated

Jan 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin James Petersen, DC

Title

President

Phone

(208) 337-8412

Specialties & licenses 1

Addresses

Other names 1

• EWC Doing business as

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.

• James Tyler Petersen, D.C.

  • Chiropractor
  • Cedar City, UT
  • NPI 1134439755
  NPD (past)

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1366712077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 E MAIN ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722515",
            "telephone_number": "208-414-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 E MAIN ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722515",
            "telephone_number": "208-414-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTAL WELLNESS & CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-337-8412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EWC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katrina Davis
• Damon Cole Dejulis, PHARMD
• Dille Dental, PLLC
• Bryan L Drake, D.O.
• Shawna Eddy Eddy Kissell, PSYCHOLOGIST, LCPC
• Matthew Kai Elliott, D.O.
• Ewc Weiser PLLC (Elemental Wellness and Chiropractic)
• Family Medical Center PLLC
• Karla Fischer
• Holly Carol Freeman, CMT

• Chiropractor in Weiser, ID
• Providers in Weiser, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.