Organization Active NPI

Wellness 1St, P.C.

  • Chiropractor
  • Ebensburg, PA
National Provider Identifier
1609964642
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WELLNESS 1ST, P.C.
Practice address
1104 W High St
Unit 4a
Ebensburg, PA 15931-1707
Phone
(814) 472-9355
Fax
(814) 472-0886
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Dr. John David Brouse, D.C.NPI 1689764797
Title
President
Phone
(814) 472-9355

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1104 W High St
Unit 4a
Ebensburg, PA 15931-1707

Mailing address

1104 W High St
Unit 4a
Ebensburg, PA 15931-1707
Phone (814) 472-9355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070426000185 PA Part B Supplier - Clinic/Group Practice 7810093549 Receives reassigned benefits from 1 practitioner
Practice locations: Ebensburg, PA

National Provider Directory

National Provider Directory

Locations

948 W High St
Ebensburg, PA 15931
Phone (814) 472-9355

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1609964642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W HIGH ST",
            "address_2": "UNIT 4A",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311707",
            "telephone_number": "814-472-9355",
            "fax_number": "814-472-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W HIGH ST",
            "address_2": "UNIT 4A",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311707",
            "telephone_number": "814-472-9355",
            "fax_number": "814-472-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS 1ST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "BROUSE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-472-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.