NPIMap

Organization Active NPI

Wagner Family Chiropractic SC

  • Massage Therapist
  • Appleton, WI
National Provider Identifier
1134588288
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
13327-146 Issued in WI
Legal business name
WAGNER FAMILY CHIROPRACTIC SC
Practice address
N110 Brux Rd
Appleton, WI 54915-9439
Phone
(920) 968-0464
Fax
(920) 968-0482
NPI assigned
Feb 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Authorized official

Name
Dr. Michael R Wagner, DCNPI 1740283183
Title
Secretary
Phone
(920) 968-0464

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
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X 13327-146 WI Primary

Addresses

Primary practice location

N110 Brux Rd
Appleton, WI 54915-9439

Mailing address

N110 Brux Rd
Appleton, WI 54915-9439
Phone (920) 968-0464

National Provider Directory

National Provider Directory
Tax ID family
Wagner Family Chiropractic SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1134588288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N110 BRUX RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549159439",
            "telephone_number": "920-968-0464",
            "fax_number": "920-968-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N110 BRUX RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549159439",
            "telephone_number": "920-968-0464",
            "fax_number": "920-968-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER FAMILY CHIROPRACTIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "920-968-0464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "13327-146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.