NPIMap

Organization Active NPI

Dr Michael Wild LLC

  • Chiropractor
  • Henrico, VA
National Provider Identifier
1053933911
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DR MICHAEL WILD LLC
Practice address
10431 Patterson Ave
Henrico, VA 23238-5101
Phone
(804) 651-2247
NPI assigned
May 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Dr. Michael R Wild, DCNPI 1477623858
Title
Owner
Phone
(804) 651-2247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

10431 Patterson Ave
Henrico, VA 23238-5101

Mailing address

5528 Riverside Heights Way
Richmond, VA 23225-2477
Phone (804) 651-2247

Other names 1

  • Wild Chiropractic Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1053933911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 RIVERSIDE HEIGHTS WAY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232252477",
            "telephone_number": "804-651-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10431 PATTERSON AVE",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232385101",
            "telephone_number": "804-651-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MICHAEL WILD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "WILD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-651-2247",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wild Chiropractic Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.