NPIMap

Organization Active NPI

Freedom Chiropractic Inc

Doing business as ProWellness Chiropractic

  • Chiropractor
  • Fishers, IN
National Provider Identifier
1992181127
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002407A Issued in IN
Legal business name
FREEDOM CHIROPRACTIC INC
Doing business as
ProWellness Chiropractic
Practice address
11876 Olio Rd
#500
Fishers, IN 46037-9765
Phone
(317) 595-9620
Fax
(317) 595-9630
NPI assigned
Aug 11, 2015
Last updated
Nov 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Authorized official

Name
Dr. David Jonathan Evans, D.C.NPI 1245477330
Title
President
Phone
(317) 508-7127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 08002407A IN Primary

Addresses

Primary practice location

11876 Olio Rd
#500
Fishers, IN 46037-9765

Mailing address

11876 Olio Rd
#500
Fishers, IN 46037-9765
Phone (317) 595-9620

Other names 1

  • ProWellness Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160428000070 IN Part B Supplier - Clinic/Group Practice 2466751391 Receives reassigned benefits from 4 practitioners
Practice locations: Fishers, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1992181127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11876 OLIO RD",
            "address_2": "#500",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379765",
            "telephone_number": "317-595-9620",
            "fax_number": "317-595-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11876 OLIO RD",
            "address_2": "#500",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379765",
            "telephone_number": "317-595-9620",
            "fax_number": "317-595-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-508-7127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002407A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProWellness Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.