Organization Active NPI

Atlas Chiropractic & Wellness, PC

  • Chiropractor
  • Spartanburg, SC
National Provider Identifier
1154763829
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ATLAS CHIROPRACTIC & WELLNESS, PC
Practice address
115 Southport Rd Ste B
Spartanburg, SC 29306-3814
Phone
(864) 804-6612
Fax
(864) 488-2216
NPI assigned
Jul 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Dr. Chad Richard Wagner, DCNPI 1164602009
Title
President
Phone
(864) 488-0410

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

115 Southport Rd Ste B
Spartanburg, SC 29306-3814

Mailing address

PO Box 2068
Gaffney, SC 29342-2068
Phone (864) 488-0410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160902001487 SC Part B Supplier - Clinic/Group Practice 0446546253 Receives reassigned benefits from 2 practitioners
Practice locations: Spartanburg, SC

National Provider Directory

National Provider Directory

Locations

115 Southport Rd
Ste B
Spartanburg, SC 29306
Phone (864) 804-6612

Practitioners & affiliated clinicians

Practitioners 2

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": "1374537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1154763829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2068",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293422068",
            "telephone_number": "864-488-0410",
            "fax_number": "864-488-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SOUTHPORT RD STE B",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063814",
            "telephone_number": "864-804-6612",
            "fax_number": "864-488-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS CHIROPRACTIC & WELLNESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-23",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-488-0410",
        "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": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.