MICHIANA WELLNESS AND LONGEVITY CLINIC, INC. (NPI# 1306954466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306954466 |
| Entity Type | Organization |
| Organization Name | MICHIANA WELLNESS AND LONGEVITY CLINIC, INC. |
| Practice Address |
605 W Edison Rd Suite G Mishawaka IN 46545-8823 |
| Practice Telephone | 5742584444 |
| Practice Fax Number | 5742584445 |
| Mailing Telephone | 5742584444 |
| Mailing Fax Number | 5742584445 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2016-03-30 |
| Authorized Official Name | DR. WILLIAM JAMES LYDEN (PRESIDENT & CEO) |
| Authorized Official Telephone | 5742584444 |
| Authorized Official Credential | D.C., DABCI, DCB |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NI0900X |
Chiropractor Specialization: Internist |
08002006A | IN | Chiropractic Providers |
| Street Address |
605 W EDISON RD SUITE G |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46545-8823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710974068 | Northern Indiana Interim Healthcare Company LLC | Home Health | 605 W Edison Rd, Suite H, Mishawaka, IN 46545-8823 | 2005-10-03 |
| 1184030132 | Yi Yang | Massage Therapist | 605 W Edison Rd, Suite C, Mishawaka, IN 46545-8823 | 2014-07-09 |
| 1437278652 | Northern Indiana Interim Healthcare | Home Health | 605 W Edison Rd, Suite H, Mishawaka, IN 46545-8823 | 2007-03-28 |
| 1710900469 | William James Lyden | Chiropractor | 605 W Edison Rd, Suite G, Mishawaka, IN 46545-8823 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824103 | Senior Helpers | In Home Supportive Care | 230 Catalpa Drive Suite B, Mishawaka, IN 46545 | 2019-08-01 |
| 1093272114 | Candice Marie Greathouse | Physical Therapy Assistant | 3630 Hickory Road, Mishawaka, IN 46545 | 2019-02-25 |
| 1639662596 | Mishawaka Rcf Lp | Assisted Living Facility | 3630 Hickory Rd, Mishawaka, IN 46545 | 2018-06-14 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1699203612 | Paridhie Vasudevan | Dentist | 6502 Grape Rd Ste 882, Mishawaka, IN 46545 | 2017-06-03 |
| 1780134650 | Ossip Optometry, PC | Optometrist | 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 | 2016-10-04 |
| 1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
| 1558759654 | Spine and Joint Associates of Plymouth, Inc | Chiropractor | 229 Red Coach, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1609264795 | Spine and Joint Associates of Mishawaka, Inc | Chiropractor | 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1508260795 | Maribel Smith | Counselor | 2989 Heritage Ct, Mishawaka, IN 46545 | 2014-10-16 |
| Find all providers in zip 46545 | ||||
| Taxonomy Code | 111NI0900X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Internist |
| The chiropractic internist may serve as a primary care physician or may see patients referred from other providers for evaluation and co-management. Evaluation is focused on the early detection of functional, nutritional, and pathological disorders. A chiropractic internist utilizes the diagnostic instruments necessary for proper examination. In cases where laboratory examination is necessary, a chiropractic internist utilizes a recognized reference laboratory facility. A chiropractic internist may manage his or her own cases or may refer to another specialist when prudent to do so. The chiropractic internist utilizes documented natural therapies, therapeutic lifestyle changes, patient education and other resources to promote patient health and avoidance of disease. |
| Notes: Source: American Chiropractic Association, 2008 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821196353 | Gary Knutson | Chiropractor | 840 W 17th St Ste 5, Bloomington, IN 47404-3379 | 2006-09-20 |
| 1548280019 | Timothy Joseph Gurrola | Chiropractor | 1405 E Lincolnway, Suite A, La Porte, IN 46350-8023 | 2006-07-20 |
| 1821028937 | Brian Charles Mcguckin | Chiropractor | 412 Marquette St, Valparaiso, IN 46383-2563 | 2006-07-04 |
| 1306017157 | Mcguckin Chiropractic PC | Chiropractor | 412 Marquette St, Valparaiso, IN 46383-2563 | 2008-03-20 |
| 1447303979 | Robert C Prather Chiropractor PC | Chiropractor | 8902 N Meridian St Ste 101, Indianapolis, IN 46260-5306 | 2007-01-19 |
| 1598813008 | Robert C. Prather | Chiropractor | 8902 N Meridian St Ste 101, Indianapolis, IN 46260-5306 | 2007-01-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.