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21ST CENTURY TOTAL WELLNESS, LLC
NPI 1043412711
Specialist in Demotte, IN

Active since June 04, 2007
5522 E 989 N, DEMOTTE, IN 46310(219) 345-3892 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About 21st Century Total Wellness, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

21ST CENTURY TOTAL WELLNESS, LLC (NPI 1043412711) is a healthcare organization registered as a specialist in Demotte, Indiana and active in the NPI registry since June 2007. The organization lists Edgar Daniel Prater, Resident Agent, as its authorized official.

NPPES Registry Identity

NPI1043412711
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business Name21ST CENTURY TOTAL WELLNESS, LLC
Location Address5522 E 989 NDemotte, IN 46310-8016
Mailing Address5522 E 989 NDemotte, IN 46310-8016 · (219) 345-3892
Phone(219) 345-3892
Organization SubpartNo
Authorized OfficialEdgar Daniel PraterResident Agent · (219) 756-4695
Enumeration DateJune 4, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1043412711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
5522 E 989 N, Demotte, IN 46310
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JILL BROGDON OTR
Specialist
5522 E 989 N
DEMOTTE, IN 46310
Jasper County (219) 756-4695
MRS. CHRISTINA GUTIERREZ OTR
Specialist
5522 E 989 N
DEMOTTE, IN 46310
Jasper County (219) 756-4695

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 21st Century Total Wellness, LLC's NPI number?

The NPI number for 21st Century Total Wellness, LLC is 1043412711. It was assigned to this organization in the NPPES registry on June 4, 2007.

Where is 21st Century Total Wellness, LLC located?

21st Century Total Wellness, LLC is located at 5522 E 989 N, Demotte, IN 46310. The listed phone number is (219) 345-3892.

What is 21st Century Total Wellness, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for 21st Century Total Wellness, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.