NPIMap

Organization Active NPI

PK Health and Wellness LLC

  • Chiropractor
  • Natick, MA
National Provider Identifier
1902548787
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PK HEALTH AND WELLNESS LLC
Practice address
6 Union St Ste 1B
Natick, MA 01760-4784
Phone
(617) 257-5180
NPI assigned
Apr 11, 2022
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Pheng Bun Kouch, DCNPI 1659385623
Title
Owner
Phone
(508) 654-3500

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

6 Union St Ste 1B
Natick, MA 01760-4784

Mailing address

6 Union St Ste 1B
Natick, MA 01760-4784
Phone (617) 257-5180

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240506000781 MA Part B Supplier - Clinic/Group Practice 4486094679 Receives reassigned benefits from 3 practitioners
Practice locations: Natick, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1902548787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 UNION ST STE 1B",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017604784",
            "telephone_number": "617-257-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 UNION ST STE 1B",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017604784",
            "telephone_number": "617-257-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PK HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-11",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "KOUCH",
        "authorized_official_first_name": "PHENG",
        "authorized_official_middle_name": "BUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-654-3500",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natick, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.