Waggener Chiropractic and Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038012923 Issued in IL

Legal business name

WAGGENER CHIROPRACTIC AND WELLNESS CENTER LLC

Practice address

7012 Kingsmill CT
Springfield, IL 62711

Phone

(217) 679-3637

NPI assigned

Apr 19, 2018

Organization subpart

No

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

Authorized official

Name

Samantha Ariel Mayberry, DCNPI 1164883526

Title

Owner/Chiropractor

Phone

(217) 679-3637

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Samantha Ariel Mayberry, DC

  • Chiropractor
  • Springfield, IL
  • NPI 1164883526
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526515200000",
    "number": "1114414620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 KINGSMILL CT",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117387",
            "telephone_number": "121-767-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7012 KINGSMILL CT",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62711",
            "telephone_number": "217-679-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGGENER CHIROPRACTIC AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-05-17",
        "status": "A",
        "authorized_official_last_name": "MAYBERRY",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "ARIEL",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "217-679-3637",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Voyles
• Wabash Family Practice Center Lab
• Michealle Wade
• Terence Edward Wade, M.D.
• Cynthia Martin Wadsworth, LCSW
• Emily Beth Waggener, DNP, CRNA
• Aparna Ashutosh Wagle Shukla, MD
• Erik Wagner
• Genevieve Amanda Wagner, DPT
• Madeline Wagner, CRNA

• Chiropractor in Springfield, IL
• Providers in Springfield, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.