Organization Active NPI

Wellness Way Eau Claire LLC

  • Chiropractor
  • Eau Claire, WI
National Provider Identifier
1407581960
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WELLNESS WAY EAU CLAIRE LLC
Practice address
4210 Southtowne Drive
Eau Claire, WI 54701-2635
Phone
(715) 598-1829
NPI assigned
Jul 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Authorized official

Name
Patrick Flynn, DC
Title
Owner
Phone
(920) 328-5339

Specialties & licenses 1

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

Addresses

Primary practice location

4210 Southtowne Drive
Eau Claire, WI 54701-2635

Mailing address

4210 Southtowne Drive
Eau Claire, WI 54701-2635
Phone (715) 598-1829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220902002122 WI Part B Supplier - Clinic/Group Practice 1850775255 Receives reassigned benefits from 2 practitioners
Practice locations: Eau Claire, WI

National Provider Directory

National Provider Directory

Locations

4410 Golf Ter
Ste 120
Eau Claire, WI 54701

4210 Southtowne Dr
Eau Claire, WI 54701
Phone (715) 598-1829

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1407581960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 SOUTHTOWNE DRIVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012635",
            "telephone_number": "715-598-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 SOUTHTOWNE DRIVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012635",
            "telephone_number": "715-598-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS WAY EAU CLAIRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-19",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-328-5339",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.