NPIMap

Organization Active NPI

Live Well Chiropractic and Wellness Center

  • Nutrition Chiropractor
  • Hurst, TX
National Provider Identifier
1821260621
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
10449 Issued in TX
Legal business name
LIVE WELL CHIROPRACTIC AND WELLNESS CENTER
Practice address
749 Lonesome Dove TRL
Hurst, TX 76054-6018
Phone
(817) 485-9355
Fax
(817) 427-9355
NPI assigned
Apr 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
Dr. Jeniifer E Ridley, D.C.
Title
Doctor
Phone
(817) 485-9355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN1001X 10449 TX Primary

Addresses

Primary practice location

749 Lonesome Dove TRL
Hurst, TX 76054-6018

Mailing address

749 Lonesome Dove TRL
Hurst, TX 76054-6018
Phone (817) 485-9355

National Provider Directory

National Provider Directory

Locations

749 Lonesome Dove Trl
Hurst, TX 76054
Phone (817) 485-9355

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": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1821260621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 LONESOME DOVE TRL",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760546018",
            "telephone_number": "817-485-9355",
            "fax_number": "817-427-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 LONESOME DOVE TRL",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760546018",
            "telephone_number": "817-485-9355",
            "fax_number": "817-427-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL CHIROPRACTIC AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "RIDLEY",
        "authorized_official_first_name": "JENIIFER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "817-485-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "TX",
            "license": "10449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.