Jerika PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

10088 Issued in TX

Legal business name

JERIKA PA

Practice address

466 Mid Cities Blvd
Hurst, TX 76054-2430

Phone

(817) 281-9040

Fax

(817) 281-4249

NPI assigned

Jul 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jessica Stangenwald Wilson, DC

Title

President

Phone

(817) 281-9040

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Body Tune-Up Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1861692576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 MID CITIES BLVD",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760542430",
            "telephone_number": "817-281-9040",
            "fax_number": "817-281-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 MID CITIES BLVD",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760542430",
            "telephone_number": "817-281-9040",
            "fax_number": "817-281-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERIKA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "STANGENWALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-281-9040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, GROUP BILLING N",
            "identifier": "00704Z",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Body Tune-Up",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffery K Hawkins, MD, PLLC
• Jamie Dale Jenkins, M.S., CCC/SLP
• Unknown Jenny Ann George
• Mary Katherine Jensen, CF-SLP
• Tricia Jenson
• Irene Jideofor, FNP
• Antonio Jimenez, DC
• Jin Lin Dentistry PLLC
• Karan Tulshi Jiva, DDS
• JLM Home Care LLC

• Chiropractor in Hurst, TX
• Providers in Hurst, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.