New Wave Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

NEW WAVE CHIROPRACTIC LLC

Practice address

829 Main St Ste 6
Longmont, CO 80501-4954

Phone

(303) 772-7337

Fax

(720) 378-6541

NPI assigned

May 27, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Carissa Supry, DC

Title

DC and Owner

Phone

(303) 772-7337

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1689297400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 MAIN ST STE 6",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805014954",
            "telephone_number": "303-772-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 MAIN ST STE 6",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805014954",
            "telephone_number": "303-772-7337",
            "fax_number": "720-378-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW WAVE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "SUPRY",
        "authorized_official_first_name": "CARISSA",
        "authorized_official_title_or_position": "DC AND OWNER",
        "authorized_official_telephone_number": "303-772-7337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.