Organization Active NPI

Chiropractic Solutions of West Lafayette, LLC

  • Chiropractor
  • Lafayette, IN
National Provider Identifier
1811337322
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002587A Issued in IN
Legal business name
CHIROPRACTIC SOLUTIONS OF WEST LAFAYETTE, LLC
Practice address
3005 Greenbush St
Lafayette, IN 47904-2435
Phone
(765) 838-3489
Fax
(765) 838-3954
NPI assigned
Jun 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Authorized official

Name
Dr. Jennifer Nicole Weida, D.C.NPI 1790065753
Title
Owner/Doctor
Phone
(765) 838-3489

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 08002587A IN Primary

Addresses

Primary practice location

3005 Greenbush St
Lafayette, IN 47904-2435

Mailing address

3005 Greenbush St
Lafayette, IN 47904-2435
Phone (765) 838-3489

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130724000365 IN Part B Supplier - Clinic/Group Practice 0648411231 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, IN

National Provider Directory

National Provider Directory

Locations

3005 Greenbush St
Lafayette, IN 47904
Phone (765) 447-3103

3451 Wyndham Way
Ste A
West Lafayette, IN 47906
Phone (765) 543-5100

Practitioners & affiliated clinicians

Practitioners 6

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": "1372377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1811337322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042435",
            "telephone_number": "765-838-3489",
            "fax_number": "765-838-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042435",
            "telephone_number": "765-838-3489",
            "fax_number": "765-838-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC SOLUTIONS OF WEST LAFAYETTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-28",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "WEIDA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "765-838-3489",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002587A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.