Organization Active NPI

Hennington Wellness Center LLC

  • Chiropractor
  • McComb, MS
National Provider Identifier
1659776946
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1043 Issued in MS
Legal business name
HENNINGTON WELLNESS CENTER LLC
Practice address
220 Scott Dr
McComb, MS 39648-3622
Phone
(601) 680-0371
Fax
(601) 680-0380
NPI assigned
Oct 29, 2014
Last updated
Oct 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Authorized official

Name
Stephen Hennington, DCNPI 1124116777
Title
Owner
Phone
(601) 680-0371

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
Chiropractor 111N00000X 1043 MS Primary

Addresses

Primary practice location

220 Scott Dr
McComb, MS 39648-3622

Mailing address

220 Scott Dr
McComb, MS 39648-3622
Phone (601) 680-0371

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150122000663 MS Part B Supplier - Clinic/Group Practice 8628392602 Receives reassigned benefits from 1 practitioner
Practice locations: McComb, MS

National Provider Directory

National Provider Directory

Locations

220 Scott Dr
McComb, MS 39648
Phone (601) 680-0371

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1659776946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SCOTT DR",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483622",
            "telephone_number": "601-680-0371",
            "fax_number": "601-680-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SCOTT DR",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483622",
            "telephone_number": "601-680-0371",
            "fax_number": "601-680-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENNINGTON WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "HENNINGTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-680-0371",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.