Individual provider Active NPI

Michelle Lynn Wattier, D.C.

  • Chiropractor
  • Murray, UT
National Provider Identifier
1881921286
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7335305-1202 Issued in UT
Practice address
495 E 4500 S
Suite 202
Murray, UT 84107-2766
Phone
(801) 281-1688
Fax
(801) 281-5544
NPI assigned
Nov 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7335305-1202 UT Primary

Addresses

Primary practice location

495 E 4500 S
Suite 202
Murray, UT 84107-2766

Mailing address

495 E 4500 S
Suite 202
Murray, UT 84107-2766
Phone (801) 281-1688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120514000518 IA Practitioner - Chiropractic 1456545664 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7335305-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Waterloo Chiropractic Center PLLC Chiropractor CurrentSince Aug 1, 2020 Accepting new patients

Locations

3731 Kimball Ave
Waterloo, IA 50702
Phone (319) 231-4779

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1881921286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 E 4500 S",
            "address_2": "SUITE 202",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841072766",
            "telephone_number": "801-281-1688",
            "fax_number": "801-281-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 E 4500 S",
            "address_2": "SUITE 202",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841072766",
            "telephone_number": "801-281-1688",
            "fax_number": "801-281-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTIER",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "7335305-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.