Embody Wellness Chiropractic Center PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EMBODY WELLNESS CHIROPRACTIC CENTER PLLC

Doing business as

Embody Wellness Chiropractic Center PLLC

Practice address

80 Acoma Blvd S Ste 104
Lake Havasu City, AZ 86403-6926

Phone

(928) 453-1055

Fax

(928) 453-1057

NPI assigned

Jun 29, 2022

Last updated

Mar 4, 2025By 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

Shelley Bengard, DCNPI 1891940706

Title

Owner

Phone

(714) 396-2284

Specialties & licenses 1

Addresses

Other names 2

• Embody Wellness Chiropractic Center Former legal business name
• Embody Wellness Chiropractic Center PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Tax ID family

Embody Chiropractic Center PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Embody Chiropractic Center PLLC

  • Chiropractor
  • Lake Havasu City, AZ
  • NPI 1619773264
  NPD tax ID

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.

• Shelley Ann Bengard, D.C.

  • Chiropractor
  • Lake Havasu City, AZ
  • NPI 1891940706
  Medicare reassignment NPD Authorized official
• Brooke Foltz, LMP

  • Massage Therapist
  • Lake Havasu City, AZ
  • NPI 1326770363

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1710619598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ACOMA BLVD S STE 104",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036926",
            "telephone_number": "928-453-1055",
            "fax_number": "928-453-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ACOMA BLVD S STE 104",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036926",
            "telephone_number": "928-453-1055",
            "fax_number": "928-453-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODY WELLNESS CHIROPRACTIC CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "BENGARD",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-396-2284",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embody Wellness Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Embody Wellness Chiropractic Center PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Embody Wellness Chiropractic Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Daniel Rawn Emig, M.D.
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• Enduro Medical Enterprises, LLC
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• Chiropractor in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.