Organization Active NPI

Holmberg Wellness Group, LLC

  • Chiropractor
  • Wichita, KS
National Provider Identifier
1891027157
Registry record updated Feb 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-04872 Issued in KS
Legal business name
HOLMBERG WELLNESS GROUP, LLC
Practice address
4709 E Eagles Landing St
Wichita, KS 67220-5506
Phone
(316) 734-9049
NPI assigned
Feb 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2010

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

Authorized official

Name
Gregory Lee Holmberg, D.C.NPI 1225060536
Title
President
Phone
(316) 734-9049

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 01-04872 KS Primary

Addresses

Primary practice location

4709 E Eagles Landing St
Wichita, KS 67220-5506

Mailing address

5846 W 21St St N
Wichita, KS 67205-1777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100818000706 KS Part B Supplier - Clinic/Group Practice 2668506262 Receives reassigned benefits from 5 practitioners
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory

Locations

5846 W 21st St N
Wichita, KS 67205

Practitioners & affiliated clinicians

Practitioners 5

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": "1265760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1891027157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5846 W 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 E EAGLES LANDING ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672205506",
            "telephone_number": "316-734-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLMBERG WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-10",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "HOLMBERG",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-734-9049",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-04872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.