Organization Active NPI

Bodywise Chiropractic PLLC

  • Chiropractor
  • Tempe, AZ
National Provider Identifier
1790968477
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7878 Issued in AZ
Legal business name
BODYWISE CHIROPRACTIC PLLC
Practice address
4685 S Ash Ave
Suite H-1
Tempe, AZ 85282-6857
Phone
(480) 775-2593
Fax
(480) 621-5485
NPI assigned
Dec 17, 2007
Last updated
Dec 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Authorized official

Name
Dr. Barbara J Bennett, D.C.NPI 1093751307
Title
Owner
Phone
(480) 440-4511

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 7878 AZ Primary

Addresses

Primary practice location

4685 S Ash Ave
Suite H-1
Tempe, AZ 85282-6857

Mailing address

4685 S Ash Ave
Suite H-1
Tempe, AZ 85282-6857
Phone (480) 775-2593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080130000739 AZ Part B Supplier - Clinic/Group Practice 4486736345 Receives reassigned benefits from 1 practitioner
Practice locations: Tempe, AZ

National Provider Directory

National Provider Directory

Locations

4685 S Ash Ave
Ste H-1
Tempe, AZ 85282
Phone (480) 620-8660

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": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1790968477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 S ASH AVE",
            "address_2": "SUITE H-1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826857",
            "telephone_number": "480-775-2593",
            "fax_number": "480-621-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 S ASH AVE",
            "address_2": "SUITE H-1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826857",
            "telephone_number": "480-775-2593",
            "fax_number": "480-621-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODYWISE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2009-12-14",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-440-4511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.