White Mountain Chiropractic Inc.

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

1375 Issued in NM

Legal business name

WHITE MOUNTAIN CHIROPRACTIC INC.

Practice address

500 Mechem Dr
Suite C
Ruidoso, NM 88345-6949

Phone

(575) 257-7970

Fax

(575) 257-7970

NPI assigned

Sep 10, 2012

Last updated

Oct 16, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Wayne Klinekole III, D.C., DACNBNPI 1093720864

Title

President

Phone

(575) 257-7970

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

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.

• Bruce Wayne Klinekole, D.C., D.A.C.N.B.

  • Neurology Chiropractor
  • Ruidoso, NM
  • NPI 1093720864
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1962751669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MECHEM DR",
            "address_2": "SUITE C",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456949",
            "telephone_number": "575-257-7970",
            "fax_number": "575-257-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MECHEM DR",
            "address_2": "SUITE C",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456949",
            "telephone_number": "575-257-7970",
            "fax_number": "575-257-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MOUNTAIN CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "KLINEKOLE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "575-257-7970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.C., DACNB"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "NM",
            "license": "1375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L4208",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "585929590",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry W. Washam, LPCC
• Sally Lutrick Waters, DMD
• Tialana Lynn Watts, CNP
• Wellcare, Inc. (Enhabit Hospice)
• Wellcare, Inc. (Enhabit Home Health)
• White Mountain Wellness LLC
• Anson Mardell Whitton, RPH
• Michael Dale Widener, DN
• Debra Wilcox, LMT
• Julie Wilkinson, LPCC

• Neurology Chiropractor in Ruidoso, NM
• Providers in Ruidoso, NM by specialty
• Neurology Chiropractor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.