Organization Active NPI

Back to Wellness Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Bend, OR
National Provider Identifier
1780229112
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
BACK TO WELLNESS MEDICAL CENTER
Practice address
2669 NE Twin Knolls Dr Ste 208
Bend, OR 97701-6206
Phone
(541) 633-6563
Fax
(541) 550-2218
NPI assigned
Nov 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Authorized official

Name
Dr. Helmut Erwin Eichner, CHIROPRACTORNPI 1497192827
Title
Director
Phone
(541) 633-6563

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

2669 NE Twin Knolls Dr Ste 208
Bend, OR 97701-6206

Mailing address

2669 NE Twin Knolls Dr Ste 208
Bend, OR 97701-6206
Phone (541) 633-6563

Other identifiers 1

IdentifierTypeStateIssuer
500665892MedicaidOR

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.

NPI Registry JSON

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1780229112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2669 NE TWIN KNOLLS DR STE 208",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016206",
            "telephone_number": "541-633-6563",
            "fax_number": "541-550-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 NE TWIN KNOLLS DR STE 208",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016206",
            "telephone_number": "541-633-6563",
            "fax_number": "541-550-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO WELLNESS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-08",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "EICHNER",
        "authorized_official_first_name": "HELMUT",
        "authorized_official_middle_name": "ERWIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "541-633-6563",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CHIROPRACTOR"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500665892",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.