NPIMap

Organization Active NPI

Olympus Family Wellness Center, P.C.

  • Chiropractor
  • Pocatello, ID
National Provider Identifier
1750420576
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1232 Issued in ID
Legal business name
OLYMPUS FAMILY WELLNESS CENTER, P.C.
Practice address
1598 Delphic Way
Suite a-2
Pocatello, ID 83201-2285
Phone
(208) 232-0220
Fax
(208) 237-9569
NPI assigned
Feb 6, 2007
Last updated
Aug 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Clinton E. Youngberg, D.C.NPI 1356480131
Title
Owner
Phone
(208) 232-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-1232 ID Primary

Addresses

Primary practice location

1598 Delphic Way
Suite a-2
Pocatello, ID 83201-2285

Mailing address

1598 Delphic Way
Suite a-2
Pocatello, ID 83201-2285
Phone (208) 232-0220

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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1750420576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 DELPHIC WAY",
            "address_2": "SUITE A-2",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012285",
            "telephone_number": "208-232-0220",
            "fax_number": "208-237-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1598 DELPHIC WAY",
            "address_2": "SUITE A-2",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012285",
            "telephone_number": "208-232-0220",
            "fax_number": "208-237-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPUS FAMILY WELLNESS CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "YOUNGBERG",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-232-0200",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.