Wellness Worx Center PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH8923 Issued in FL

Legal business name

WELLNESS WORX CENTER PLLC

Practice address

2495 Enterprise Rd
Ste104
Clearwater, FL 33763-1795

Phone

(727) 474-9729

Fax

(727) 474-9947

NPI assigned

Apr 15, 2010

Last updated

Apr 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Glen Charles Pettersen, DCNPI 1386865319

Title

Owner

Phone

(727) 474-9729

Specialties & licenses 2

Addresses

Other identifiers 6

Locations

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.

• Glen C Pettersen, DC

  • Chiropractor
  • Clearwater, FL
  • NPI 1386865319
  NPD (past) Authorized official

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1871819870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 ENTERPRISE RD",
            "address_2": "STE104",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631795",
            "telephone_number": "727-474-9729",
            "fax_number": "727-474-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 ENTERPRISE RD",
            "address_2": "STE104",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631795",
            "telephone_number": "727-474-9729",
            "fax_number": "727-474-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS WORX CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "PETTERSEN",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-474-9729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8923",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8772",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9067913",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY HEALTH",
            "identifier": "1038157",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1147626",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1538210",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FL",
            "identifier": "71494",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "656080",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Nellie Welch, PA
• Auri Welch, LMHC
• Brandon Welch, PHARMD.
• Wellbeingme LLC
• Wellness Firm LLC
• Julie Ann Wells, LCSW
• Karen Sue Wells, RN
• Sarah Wells
• Amy W Welsh, MSPT, OCS
• Sharon Welsh, ARNP

• Chiropractor in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.