Organization Active NPI

Advanced Wellness Center Inc

  • Chiropractor
  • Columbus, OH
National Provider Identifier
1487691309
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3427 Issued in OH
Legal business name
ADVANCED WELLNESS CENTER INC
Practice address
1351 King Ave
Columbus, OH 43212-2220
Phone
(614) 488-6820
Fax
(614) 488-6830
NPI assigned
May 31, 2006
Last updated
Sep 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Authorized official

Name
Dr. Bradley Troy Walker, DCNPI 1952583502
Title
President
Phone
(614) 488-6820

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3428 OH
Chiropractor 111N00000X 3427 OH Primary

Addresses

Primary practice location

1351 King Ave
Columbus, OH 43212-2220

Mailing address

1351 King Ave
Columbus, OH 43212-2220
Phone (614) 488-6820

Other identifiers 1

IdentifierTypeStateIssuer
000000321967OtherOHBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080206000633 OH Part B Supplier - Clinic/Group Practice 7416030911 Receives reassigned benefits from 4 practitioners
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory

Locations

1351 King Ave
Columbus, OH 43212
Phone (614) 488-6820

1580 King Ave
Ste 204
Columbus, OH 43212
Phone (614) 488-6820

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1487691309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 KING AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432122220",
            "telephone_number": "614-488-6820",
            "fax_number": "614-488-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 KING AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432122220",
            "telephone_number": "614-488-6820",
            "fax_number": "614-488-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-488-6820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3428",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000321967",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.