Active NPI
Back to Wellness Medical Center
- Physical Medicine & Rehabilitation Physician
- Bend, OR
National Provider Identifier
1780229112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Helmut Erwin Eichner, CHIROPRACTOR
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500665892 | Medicaid | OR |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Bend, OR
- NPI 1497192827
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.