Organization Active NPI

Provision Chiropractic and Wellness, LLC

  • Chiropractor
  • Lincoln, NE
National Provider Identifier
1891376919
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PROVISION CHIROPRACTIC AND WELLNESS, LLC
Practice address
2755 Jamie LN Ste 9
Lincoln, NE 68516-7750
Phone
(531) 500-2412
Fax
(531) 500-4520
NPI assigned
Apr 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Authorized official

Name
Dr. Brad Hochstein, DCNPI 1124358262
Title
Owner
Phone
(402) 369-1080

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: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2755 Jamie LN Ste 9
Lincoln, NE 68516-7750

Mailing address

2755 Jamie LN Ste 9
Lincoln, NE 68516-7750
Phone (531) 500-2412

Other names 1

  • Provision Chiropractic and Wellness Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brad@provisionlincoln.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210427002612 NE Part B Supplier - Clinic/Group Practice 2567870777 Receives reassigned benefits from 1 practitioner
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Locations

2755 Jamie Ln
Ste 9
Lincoln, NE 68516
Phone (531) 500-2412

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": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1891376919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 JAMIE LN STE 9",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685167750",
            "telephone_number": "531-500-2412",
            "fax_number": "531-500-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 JAMIE LN STE 9",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685167750",
            "telephone_number": "531-500-2412",
            "fax_number": "531-500-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION CHIROPRACTIC AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "HOCHSTEIN",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-369-1080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brad@provisionlincoln.com",
            "affiliation": "N",
            "endpointDescription": "Clinic Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2755 Jamie Ln Ste 9",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685167750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Provision Chiropractic and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.