NPIMap

Organization Active NPI

360 Wellness LLC

Doing business as 360 Wellness Chiropractic & Physical Therapy

  • Chiropractor
  • Madison, WI
National Provider Identifier
1376168989
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
360 WELLNESS LLC
Doing business as
360 Wellness Chiropractic & Physical Therapy
Practice address
504 S Yellowstone Lane
Madison, WI 53719
Phone
(847) 558-9155
NPI assigned
Jun 9, 2020
Last updated
Jun 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Dr. Nathan James AndersenNPI 1023633757
Title
Co-Owner
Phone
(847) 558-9155

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

504 S Yellowstone Lane
Madison, WI 53719

Mailing address

504 S Yellowstone Lane
Madison, WI 53719
Phone (847) 558-9155

Other names 1

  • 360 Wellness Chiropractic & Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

504 S Yellowstone Dr
Madison, WI 53719
Phone (715) 498-4729

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": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1376168989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 S YELLOWSTONE LANE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53719",
            "telephone_number": "847-558-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 S YELLOWSTONE LANE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53719",
            "telephone_number": "847-558-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "847-558-9155",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "360 Wellness Chiropractic & Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.