NPIMap

Organization Active NPI

Life Chiropractic LLC

  • Health Maintenance Organization
  • Longmont, CO
National Provider Identifier
1992986889
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
6119 Issued in CO
Legal business name
LIFE CHIROPRACTIC LLC
Practice address
825 Delaware Ave
Suite P103
Longmont, CO 80501-6169
Phone
(303) 678-1979
Fax
(303) 678-5577
NPI assigned
Nov 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Authorized official

Name
Dr. John R. Wendt, D.C.
Title
Owner
Phone
(303) 678-1979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 6119 CO Primary

Addresses

Primary practice location

825 Delaware Ave
Suite P103
Longmont, CO 80501-6169

Mailing address

825 Delaware Ave
Suite P103
Longmont, CO 80501-6169
Phone (303) 678-1979

National Provider Directory

National Provider Directory

Locations

825 Delaware Ave
Ph P103
Longmont, CO 80501
Phone (303) 678-1979

Practitioners & affiliated clinicians

Practitioners 3

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": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1992986889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 DELAWARE AVE",
            "address_2": "SUITE P103",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016169",
            "telephone_number": "303-678-1979",
            "fax_number": "303-678-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 DELAWARE AVE",
            "address_2": "SUITE P103",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016169",
            "telephone_number": "303-678-1979",
            "fax_number": "303-678-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "WENDT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-678-1979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CO",
            "license": "6119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.