Organization Active NPI

Wilson Family Chiropractic, LLC

  • Chiropractor
  • Houston, MO
National Provider Identifier
1659892933
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WILSON FAMILY CHIROPRACTIC, LLC
Practice address
301 S 1St St
Houston, MO 65483-1621
Phone
(417) 967-2470
NPI assigned
Jun 27, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Kalenna Jean Wilson, D.C.NPI 1013209162
Title
Doctor
Phone
(417) 967-2470

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 Primary

Addresses

Primary practice location

301 S 1St St
Houston, MO 65483-1621

Mailing address

301 S 1St St
Houston, MO 65483-1621
Phone (417) 967-2470

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170811002406 MO Part B Supplier - Clinic/Group Practice 3779854500 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, MO

National Provider Directory

National Provider Directory

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": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1659892933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S 1ST ST",
            "city": "HOUSTON",
            "state": "MO",
            "postal_code": "654831621",
            "telephone_number": "417-967-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 1ST ST",
            "city": "HOUSTON",
            "state": "MO",
            "postal_code": "654831621",
            "telephone_number": "417-967-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KALENNA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "417-967-2470",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.