Elite Chiropractic of the Ozarks, LLC – Chiropractor

Key facts

NPI: 1376041665
Entity type: Organization (NPI type 2)
Primary specialty: Chiropractor 111N00000X
License: 2018000970 (MO)
Legal business name: ELITE CHIROPRACTIC OF THE OZARKS, LLC
Practice address: 240 W Main St
West Plains, MO 65775-2726
Phone: (417) 257-2477
NPI assigned: Feb 1, 2018
Organization subpart: No

Authorized official

Name: Dr. Johna Wade, DC NPI 1831607118
Title: Owner/ Sole Physician
Phone: (417) 274-4366

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

Johna Lee Wade, DC Chiropractor · West Plains, MO · NPI 1831607118

NPD (past) Authorized official CHIROPRACTOR

National Provider Directory

Locations

240 W Main St
West Plains, MO 65775
Phone (417) 257-2477

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor Group: 193400000X SINGLE SPECIALTY GROUP	111N00000X	2018000970	MO	Yes

Addresses

Primary practice location

240 W Main St
West Plains, MO 65775-2726

Mailing address

PO Box 485
Brandsville, MO 65688-0485
Phone (417) 257-2477

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 1, 2018.

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1376041665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 485",
            "city": "BRANDSVILLE",
            "state": "MO",
            "postal_code": "656880485",
            "telephone_number": "417-257-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W MAIN ST",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752726",
            "telephone_number": "417-257-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CHIROPRACTIC OF THE OZARKS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "JOHNA",
        "authorized_official_title_or_position": "OWNER/ SOLE PHYSICIAN",
        "authorized_official_telephone_number": "417-274-4366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2018000970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

All providers in West Plains, MO · Chiropractor in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.