Active NPI
Brice Wiltgen, DC
- Chiropractor
- Surprise, AZ
National Provider Identifier
1043584881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 8744
- Practice address
- 15288 W Brookside LN Ste 139
Surprise, AZ 85374-3990 - Phone
- (623) 544-4444
- NPI assigned
- Feb 24, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 8744 | AZ | Primary |
Addresses
Primary practice location
15288 W Brookside LN Ste 139
Surprise, AZ 85374-3990
Mailing address
15288 W Brookside LN Ste 139
Surprise, AZ 85374-3990
Phone (623) 544-4444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
15288 W Brookside LN
Suite 139
Surprise, AZ 85374-3990
Phone (623) 544-4444
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Care Wellness, PLLC | Chiropractor | Current | Accepting new patients |
| Brice Wiltgen D.C., PLLC | Single Specialty | Current | Accepting new patients |
Locations
15288 W Brookside Ln
Ste 139
Surprise, AZ 85374
Phone (623) 544-4444
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Scottsdale, AZ
- NPI 1437489127
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1043584881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15288 W BROOKSIDE LN STE 139",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853743990",
"telephone_number": "623-544-4444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15288 W BROOKSIDE LN STE 139",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853743990",
"telephone_number": "623-544-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILTGEN",
"first_name": "BRICE",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-24",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "AZ",
"license": "8744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.