NPIMap

Organization Active NPI

Mountain State Spinal Care

  • Chiropractor
  • Morgantown, WV
National Provider Identifier
1861609638
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
771 Issued in WV
Legal business name
MOUNTAIN STATE SPINAL CARE
Practice address
965 Hartman Run Rd
Suite 1101
Morgantown, WV 26505-3791
Phone
(304) 292-7740
Fax
(304) 292-7741
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Dr. Lucas Chadd Watterson, D.C.NPI 1437103603
Title
Partner
Phone
(304) 292-7740

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 771 WV Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 770 WV

Addresses

Primary practice location

965 Hartman Run Rd
Suite 1101
Morgantown, WV 26505-3791

Mailing address

965 Hartman Run Rd
Suite 1101
Morgantown, WV 26505-3791
Phone (304) 292-7740

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1861609638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 HARTMAN RUN RD",
            "address_2": "SUITE 1101",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053791",
            "telephone_number": "304-292-7740",
            "fax_number": "304-292-7741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 HARTMAN RUN RD",
            "address_2": "SUITE 1101",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053791",
            "telephone_number": "304-292-7740",
            "fax_number": "304-292-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATE SPINAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "WATTERSON",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "CHADD",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "304-292-7740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "771",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.