NPIMap

Organization Active NPI

Laurent Wanner Chiropractic, Inc.

  • Health Service Clinic/Center
  • Crescent City, CA
National Provider Identifier
1720387228
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
200250 Issued in CA
Legal business name
LAURENT WANNER CHIROPRACTIC, INC.
Doing business as
Wanner Sports & Family Chiropractic
Practice address
1000 Northcrest Dr Ste 3
Crescent City, CA 95531-2317
Phone
(707) 465-4132
Fax
(707) 465-4132
NPI assigned
Mar 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Authorized official

Name
Dr. Laurent E Wanner, D.C.
Title
Doctor of Chiropractic
Phone
(707) 465-4132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 200250 CA Primary

Addresses

Primary practice location

1000 Northcrest Dr Ste 3
Crescent City, CA 95531-2317

Mailing address

1000 Northcrest Dr Ste 3
Crescent City, CA 95531-2317
Phone (707) 465-4132

Other identifiers 1

IdentifierTypeStateIssuer
DC0200250MedicaidCA

Other names 1

  • Wanner Sports & Family Chiropractic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Laurent E Wanner Chiropractic Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302220800000",
    "number": "1720387228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NORTHCREST DR STE 3",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955312317",
            "telephone_number": "707-465-4132",
            "fax_number": "707-465-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NORTHCREST DR STE 3",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955312317",
            "telephone_number": "707-465-4132",
            "fax_number": "707-465-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURENT WANNER CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-23",
        "last_updated": "2011-04-08",
        "status": "A",
        "authorized_official_last_name": "WANNER",
        "authorized_official_first_name": "LAURENT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "707-465-4132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "200250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC0200250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wanner Sports & Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crescent City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.