Organization Active NPI

Inspired Health Chiropractic & Wellness PLLC

  • Chiropractor
  • Ithaca, NY
National Provider Identifier
1417170648
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010724-1 Issued in NY
Legal business name
INSPIRED HEALTH CHIROPRACTIC & WELLNESS PLLC
Practice address
726 Willow Ave
Ithaca, NY 14850-3215
Phone
(607) 256-0641
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Authorized official

Name
Dr. Jessica E Loda, DCNPI 1598836140
Title
Owner Member
Phone
(607) 256-0641

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X010724-1 NY Primary

Addresses

Primary practice location

726 Willow Ave
Ithaca, NY 14850-3215

Mailing address

726 Willow Ave
Ithaca, NY 14850-3215
Phone (607) 256-0641

Other identifiers 1

IdentifierTypeStateIssuer
1598836140OtherNYCHIROPRACTOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070410000601 NY Part B Supplier - Clinic/Group Practice 9133224785 Receives reassigned benefits from 1 practitioner
Practice locations: Ithaca, NY

National Provider Directory

National Provider Directory

Locations

329 S Geneva St
Ithaca, NY 14850
Phone (607) 256-0641

726 Willow Ave
Ithaca, NY 14850
Phone (607) 256-0641

Practitioners & affiliated clinicians

Practitioners 1

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": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1417170648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 WILLOW AVE",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503215",
            "telephone_number": "607-256-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 WILLOW AVE",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503215",
            "telephone_number": "607-256-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSPIRED HEALTH CHIROPRACTIC & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "LODA",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER MEMBER",
        "authorized_official_telephone_number": "607-256-0641",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010724-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTOR",
            "identifier": "1598836140",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.