360 WELLNESS LLC — NPI 1376168989 (Licensed & Credentialed Chiropractic Providers

CMS-1500 Box 24J / 33a • NPI

1376168989

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

111N00000X (CMS 35)

Licensed & Credentialed Chiropractic Providers — Chiropractor

Box 32 Service Location & ZIP+4

504 S YELLOWSTONE LANE, MADISON, WI, 53719

Official NPPES Practice Location

Practice Phone & Referral Fax

(847) 558-9155

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1376168989 (360 WELLNESS LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1376168989` (NPI-2 Organization / Facility)
Provider / Legal Name	360 WELLNESS LLC
Plain-English Specialty	Licensed & Credentialed Chiropractic Providers — Chiropractor NUCC Code: `111N00000X` (Chiropractor)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	504 S YELLOWSTONE LANE, MADISON, WI, 53719
Practice Telephone / Fax	Tel: (847) 558-9155
Administrative Mailing Address	504 S YELLOWSTONE LANE, MADISON, WI, 53719
Enumeration & Last Sync	Enumerated: 2020-06-09 \| CMS Record Updated: 2020-06-09
Authorized Official	NATHAN ANDERSEN (Co-Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

504 S YELLOWSTONE LANE, MADISON, WI, 53719

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Plain-English Taxonomy & CMS Crosswalk (111N00000X)

What Does Taxonomy Code 111N00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111N00000X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 35 (Chiropractic)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Chiropractor for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (360 WELLNESS LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`225100000X` — Physical Therapist Plain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist	State: N/A \| License: `Verified` \| Primary: Secondary
`111N00000X` — Chiropractor Plain English: Licensed & Credentialed Chiropractic Providers — Chiropractor	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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360 WELLNESS LLC (NPI #1376168989)