Pure Life Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PURE LIFE CHIROPRACTIC, LLC

Practice address

7149 Whitestown Pkwy
Zionsville, IN 46077-7626

Phone

(219) 964-1188

NPI assigned

Feb 3, 2022

Last updated

Feb 29, 2024By 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. Shelby Renee WagnerNPI 1801309331

Title

Member

Phone

(317) 750-8583

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 2

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.

• Brandon James Wagner, DC

  • Chiropractor
  • Lafayette, IN
  • NPI 1801567524
  Medicare reassignment NPD
• Shelby Renee Wagner, DC

  • Chiropractor
  • Zionsville, IN
  • NPI 1801309331
  Authorized official Same address or phone

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1699428185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7149 WHITESTOWN PKWY",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460777626",
            "telephone_number": "317-750-8583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7149 WHITESTOWN PKWY",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460777626",
            "telephone_number": "219-964-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE LIFE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-03",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "317-750-8583",
        "authorized_official_name_prefix": "Dr."
    },
    "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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• Julie Lynn Quigley, LMHC
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• Deidra Taylor Rausch, PH.D.
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• Chiropractor in Zionsville, IN
• Providers in Zionsville, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.