Dullenty Chiropractic Family Wellness Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2011039215 Issued in MO

Legal business name

DULLENTY CHIROPRACTIC FAMILY WELLNESS CENTER, LLC

Practice address

805 W Pine St
Poplar Bluff, MO 63901-4956

Phone

(573) 785-2225

Fax

(573) 355-5401

NPI assigned

Jul 14, 2009

Last updated

Jun 25, 2014By 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. Kelly Rebekah Wilkerson-Dullenty, D.C.

Title

Owner/Doctor

Phone

(573) 785-2225

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Adkins Chiropractic, LLC Former legal business name

Locations

Practitioners 4

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.

• Lora Nichole Butler, LMT

  • Massage Therapist
  • Poplar Bluff, MO
  • NPI 1770807257
  NPD (past)
• Shelly Y Gresham, RNC-FNP

  • Nurse Practitioner
  • Poplar Bluff, MO
  • NPI 1063491405
  NPD (past)
• Stephen A Segall, M.D.

  • Internal Medicine Physician
  • Poplar Bluff, MO
  • NPI 1700882016
  NPD (past)
• Amar Sawar, M.D.

  • Rheumatology Physician
  • Carbondale, IL
  • NPI 1245280445
  NPD (past)

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1508095373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W PINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014956",
            "telephone_number": "573-785-2225",
            "fax_number": "573-355-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W PINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014956",
            "telephone_number": "573-785-2225",
            "fax_number": "573-355-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULLENTY CHIROPRACTIC FAMILY WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-14",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "WILKERSON-DULLENTY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "REBEKAH",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "573-785-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2011039215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1952588956",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adkins Chiropractic, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Drjerry W Long Optometry
• Gina L Duckett, LPC, NCC
• Tasheka Shaconnie Dudley
• Ramona Dugas, RN
• Darrell Wayne Dugger
• Aren Leanne Duncan
• Emily Duncan
• Katrina Casandra Duncan, COTA/L
• Rolin B Duncan, M.D.
• Christina Dunivan, PHARMD

• Chiropractor in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; 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.