Lifetime Wellness Clinic of Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1488 Issued in NE

Legal business name

LIFETIME WELLNESS CLINIC OF CHIROPRACTIC PC

Practice address

105 W E St
Elmwood, NE 68349-6113

Phone

(402) 994-2030

Fax

(402) 994-2101

NPI assigned

Oct 29, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Bryan Edward Hufstader, D.C.NPI 1407916539

Title

Owner

Phone

(402) 994-2030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Practitioners 2

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

• Bryan Edward Hufstader, D.C.

  • Chiropractor
  • Elmwood, NE
  • NPI 1407916539
  Medicare reassignment NPD Authorized official
• Sally Kate Hufstader, DC

  • Chiropractor
  • Elmwood, NE
  • NPI 1528240181
  NPD (past)

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1376897397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WEST E STREET",
            "address_2": "PO BOX 306",
            "city": "ELMWOOD",
            "state": "NE",
            "postal_code": "68349",
            "telephone_number": "402-994-2030",
            "fax_number": "402-994-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W E ST",
            "city": "ELMWOOD",
            "state": "NE",
            "postal_code": "683496113",
            "telephone_number": "402-994-2030",
            "fax_number": "402-994-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME WELLNESS CLINIC OF CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "HUFSTADER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-994-2030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elmwood-Murdock Public Schools
• Tracey Lynn Hamor
• Bobbi M Hohman
• Bryan Edward Hufstader, D.C.
• Sally Kate Hufstader, DC
• Tami Jo Mayberry, ARNP
• Elissa Rae McGill, LIMHP
• Carrie Nunez
• Sara Rundquist
• Tracey L Hamor LLC

• Chiropractor in Elmwood, NE
• Providers in Elmwood, NE by specialty
• Chiropractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.