Individual provider Active NPI

Joseph Vanwagner, DC

  • Chiropractor
  • Pittsburgh, PA
National Provider Identifier
1043628688
Registry record updated Mar 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC010915 Issued in PA
Practice address
470 Home Dr
Pittsburgh, PA 15275-1204
Phone
(412) 787-7400
Fax
(412) 787-7407
NPI assigned
Jul 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC010915 PA Primary

Addresses

Primary practice location

470 Home Dr
Pittsburgh, PA 15275-1204

Mailing address

470 Home Dr
Pittsburgh, PA 15275-1204
Phone (412) 787-7400

Other identifiers 1

IdentifierTypeStateIssuer
DC010915OtherPASTATE LISC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141006000763 PA Practitioner - Chiropractic 6709006208 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC010915PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Chiropractic and Rehabilitation LLC CurrentSince Jul 11, 2018 Accepting new patients

Locations

1 Robinson Plz
Ste 140
Pittsburgh, PA 15205
Phone (412) 489-6036

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457136000000",
    "number": "1043628688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 HOME DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751204",
            "telephone_number": "412-787-7400",
            "fax_number": "412-787-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 HOME DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751204",
            "telephone_number": "412-787-7400",
            "fax_number": "412-787-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWAGNER",
        "first_name": "JOSEPH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2016-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISC",
            "identifier": "DC010915",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.