NPIMap

Organization Active NPI

Liberation Chiropractic & Wellness, P.C.

  • Chiropractor
  • Mobile, AL
National Provider Identifier
1952789208
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2091 Issued in AL
Legal business name
LIBERATION CHIROPRACTIC & WELLNESS, P.C.
Practice address
7921 Tanner Williams Rd
Ste B
Mobile, AL 36608-8308
Phone
(251) 607-0040
NPI assigned
May 7, 2015
Last updated
May 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Authorized official

Name
Mr. Michael Bucknell, D.C.NPI 1578697207
Title
Owner
Phone
(251) 607-0040

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
Chiropractor 111N00000X 2091 AL Primary

Addresses

Primary practice location

7921 Tanner Williams Rd
Ste B
Mobile, AL 36608-8308

Mailing address

7921 Tanner Williams Rd
Ste B
Mobile, AL 36608-8308
Phone (251) 607-0040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080512000467 AL Part B Supplier - Clinic/Group Practice 5395824650 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Mobile, AL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

7921 Tanner Williams Rd
Ste B
Mobile, AL 36608
Phone (251) 607-0040

7921 Tanner Williams Rd
Ste I
Mobile, AL 36608
Phone (251) 607-0040

Practitioners & affiliated clinicians

Practitioners 4

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": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430956800000",
    "number": "1952789208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7921 TANNER WILLIAMS RD",
            "address_2": "STE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366088308",
            "telephone_number": "251-607-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7921 TANNER WILLIAMS RD",
            "address_2": "STE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366088308",
            "telephone_number": "251-607-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERATION CHIROPRACTIC & WELLNESS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2015-05-07",
        "status": "A",
        "authorized_official_last_name": "BUCKNELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-607-0040",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; 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.