NPIMap

Organization Active NPI

Family Chiropractic Wellness Center LLC

  • Chiropractor
  • Richland, WA
National Provider Identifier
1427221308
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034466 Issued in WA
Legal business name
FAMILY CHIROPRACTIC WELLNESS CENTER LLC
Practice address
110 Columbia Point Dr
Richland, WA 99352-4387
Phone
(509) 946-7692
Fax
(509) 943-8639
NPI assigned
Apr 11, 2008
Last updated
Aug 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Authorized official

Name
Dr. Angela Lorraine Sullivan, DCNPI 1396720835
Title
Chiropractor
Phone
(509) 946-7692

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF60424484 WA
Chiropractor 111N00000X CH00034466 WA Primary
Massage Therapist 225700000X NU

Addresses

Primary practice location

110 Columbia Point Dr
Richland, WA 99352-4387

Mailing address

110 Columbia Point Dr
Richland, WA 99352-4387
Phone (509) 946-7692

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080919000169 WA Part B Supplier - Clinic/Group Practice 1456428218 Receives reassigned benefits from 3 practitioners
Practice locations: Richland, WA

National Provider Directory

National Provider Directory

Locations

4001 Kennedy Rd
Ste 12
West Richland, WA 99353
Phone (509) 539-7730

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1427221308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COLUMBIA POINT DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524387",
            "telephone_number": "509-946-7692",
            "fax_number": "509-943-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 COLUMBIA POINT DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524387",
            "telephone_number": "509-946-7692",
            "fax_number": "509-943-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHIROPRACTIC WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "509-946-7692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60424484",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034466",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.