Canyon Chiropractic Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4863 Issued in CO

Legal business name

CANYON CHIROPRACTIC WELLNESS CENTER LLC

Practice address

1425 Hawk Pkwy
Suite 1
Montrose, CO 81401-6453

Phone

(970) 240-2181

Fax

(970) 240-2188

NPI assigned

Mar 22, 2011

Last updated

Mar 22, 2011By 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. Brett Lawton Edeker, D.C.NPI 1093854879

Title

Managing Member

Phone

(970) 240-2181

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

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.

• Brett Lawton Edeker, D.C.

  • Chiropractor
  • Montrose, CO
  • NPI 1093854879
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1548569155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 HAWK PKWY",
            "address_2": "SUITE 1",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016453",
            "telephone_number": "970-240-2181",
            "fax_number": "970-240-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 HAWK PKWY",
            "address_2": "SUITE 1",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016453",
            "telephone_number": "970-240-2181",
            "fax_number": "970-240-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON CHIROPRACTIC WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "EDEKER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "LAWTON",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "970-240-2181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "4863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tom G Campbell, MD
• Thomas M Canfield, MD
• Cannon Consulting LLC
• Christine Cannon, DIPL.OM, L.AC.
• Margaret Victoria Cannon, LCSW
• Caring Smiles Practice Management (Dental Care in Montrose)
• Suzanne E Carmody, FNP
• Carol Friedrich Consulting PLLC
• Carrel Chiropractic Clinic LLC
• Denise Rose Carrel, DC

• Chiropractor in Montrose, CO
• Providers in Montrose, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.