Wynne Chiropractic Clinic, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1155 Issued in AR

Legal business name

WYNNE CHIROPRACTIC CLINIC, INC

Doing business as

Butler Chiropractic Clinic

Practice address

2301 Highway 367 N
Newport, AR 72112-2325

Phone

(870) 523-5257

Fax

(870) 523-5263

NPI assigned

Jun 27, 2007

Last updated

Jul 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Douglas Butler, D.C.NPI 1790759504

Title

President

Phone

(870) 523-5257

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BUTLER CHIROPRACTIC CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Wynne Chiropractic Clinic, Inc.

  dba Newark Health & Wellness Center

  • Chiropractor
  • Newark, AR
  • NPI 1184713000

  8820280381

  Same PAC ID

Tax ID family

Butler Chiropractic Clinic2 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.

• Wynne Chiropractic Clinic, Inc.

  dba Newark Health & Wellness Center

  • Chiropractor
  • Newark, AR
  • NPI 1184713000
  NPD tax ID

Locations

Practitioners 3

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.

• Mark Douglas Butler, D.C.

  • Chiropractor
  • Newport, AR
  • NPI 1790759504
  Medicare reassignment NPD Authorized official
• Judy Clayton Butler, D.C.

  • Chiropractor
  • Newark, AR
  • NPI 1881660637
  NPD (past)
• Thomas Edward Carlyle, D.C.

  • Chiropractor
  • Memphis, TN
  • NPI 1093789042
  NPD (past)

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280102400000",
    "number": "1477759207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 HIGHWAY 367 N",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721122325",
            "telephone_number": "870-523-5257",
            "fax_number": "870-523-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HIGHWAY 367 N",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721122325",
            "telephone_number": "870-523-5257",
            "fax_number": "870-523-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNNE CHIROPRACTIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2010-07-26",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-523-5257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136123718",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BUTLER CHIROPRACTIC CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharri A Woodard
• Ralph Irwin Wray, LPC
• Vicki Lynn Wray
• Edward Wren
• Jennifer Lanelle Wynn, PHARMD
• Brandy Diane Young, M.C.D.,CCC-SLP
• Carissa Young, PHARMD
• Carla Jean Young
• Rachel Elizabeth Zachary

• Chiropractor in Newport, AR
• Providers in Newport, AR by specialty
• Chiropractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; 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.