NPIMap

Organization Active NPI

Enhanced Wellness Clinics

  • Chiropractor
  • Roswell, GA
National Provider Identifier
1801346705
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007877 Issued in GA
Legal business name
ENHANCED WELLNESS CLINICS
Practice address
622 W Crossville Rd Ste 100
Roswell, GA 30075-2560
Phone
(770) 552-7500
Fax
(888) 819-9318
NPI assigned
Oct 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Authorized official

Name
Dr. Matthew Rafael Eisen, D.C.
Title
Clinical Director
Phone
(770) 552-7500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CHIR007877 GA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CHIR009680 GA
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CHIR009709 GA

Addresses

Primary practice location

622 W Crossville Rd Ste 100
Roswell, GA 30075-2560

Mailing address

622 W Crossville Rd Ste 100
Roswell, GA 30075-2560
Phone (770) 552-7500

National Provider Directory

National Provider Directory
Tax ID family
Enhanced Wellness Clinics3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1801346705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W CROSSVILLE RD STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752560",
            "telephone_number": "770-552-7500",
            "fax_number": "888-819-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W CROSSVILLE RD STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752560",
            "telephone_number": "770-552-7500",
            "fax_number": "888-819-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED WELLNESS CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "EISEN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RAFAEL",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "770-552-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007877",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009680",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009709",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.