Essential Wellness LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ESSENTIAL WELLNESS LLC

Practice address

2309 45TH St
Highland, IN 46322-2602

Phone

(219) 922-0202

NPI assigned

Oct 15, 2020

Last updated

Oct 16, 2020By 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

Lynn McDonald

Title

Credentialing

Phone

(219) 769-1670

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602806400000",
    "number": "1487252946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 45TH ST",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 45TH ST",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222602",
            "telephone_number": "219-922-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "219-769-1670"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300029854",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maquarius7@sbcglobal.net",
            "affiliation": "N",
            "address_1": "2309 45th St",
            "city": "Highland",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463222602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Chiropractor in Highland, IN
• Providers in Highland, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.