NPIMap

Organization Active NPI

Hollywood Wellness Associates, Inc.

  • Chiropractor
  • Las Vegas, NV
National Provider Identifier
1396023222
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
B01408 Issued in NV
Legal business name
HOLLYWOOD WELLNESS ASSOCIATES, INC.
Practice address
5568 S Fort Apache Rd
Las Vegas, NV 89148-3602
Phone
(623) 399-8606
Fax
(623) 399-9958
NPI assigned
Jul 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Authorized official

Name
Matthew J Emmons, D.C.
Title
Ceo
Phone
(602) 881-5430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X B01408 NV Primary

Addresses

Primary practice location

5568 S Fort Apache Rd
Las Vegas, NV 89148-3602

Mailing address

5568 S Fort Apache Rd
Las Vegas, NV 89148-3602
Phone (623) 399-8606

Other identifiers 1

IdentifierTypeStateIssuer
B01408OtherNVLICENSE #

National Provider Directory

National Provider Directory
Tax ID family
Hollywood Wellness Associates Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1396023222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5568 S FORT APACHE RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891483602",
            "telephone_number": "623-399-8606",
            "fax_number": "623-399-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5568 S FORT APACHE RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891483602",
            "telephone_number": "623-399-8606",
            "fax_number": "623-399-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWOOD WELLNESS ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "EMMONS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-881-5430",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B01408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "B01408",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.