Active NPI
Nicholas Wuthnow, DC
- Chiropractor
- Fayetteville, AR
National Provider Identifier
1053067272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 16320
- Practice address
- 3980 W Wedington Dr Ste 14
Fayetteville, AR 72704-5791 - Phone
- (479) 435-6834
- NPI assigned
- Feb 25, 2022
- Last updated
- Feb 25, 2022
- Sex
- Male
- Sole proprietor
- No
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 | 16320 | AR | Primary |
Addresses
Primary practice location
3980 W Wedington Dr Ste 14
Fayetteville, AR 72704-5791
Mailing address
4101 W Huntington Dr Apt 2302
Rogers, AR 72758-4191
Phone (785) 201-2781
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982245387 | Other | AR | AELL SPENCER CHIROPRACTIC INC. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1335 E Independence St
Suite B
Springfield, MO 65804-4213
Phone (417) 877-7800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16320 | AR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aell Spencer Chiropractic Inc | Chiropractor | Current | Accepting new patients |
Locations
3980 W Wedington Dr
Ste 14
Fayetteville, AR 72704
Phone (479) 435-6834
Networks
- IA HMO C-SNP
- IA HMO
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645747200000",
"number": "1053067272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 W HUNTINGTON DR APT 2302",
"city": "ROGERS",
"state": "AR",
"postal_code": "727584191",
"telephone_number": "785-201-2781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3980 W WEDINGTON DR STE 14",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727045791",
"telephone_number": "479-435-6834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUTHNOW",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-25",
"last_updated": "2022-02-25",
"certification_date": "2022-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "16320",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AELL SPENCER CHIROPRACTIC INC.",
"identifier": "1982245387",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.