NPIMap

Individual provider Active NPI

Phillip T Wong, D.C.

  • Chiropractor
  • Providence, RI
National Provider Identifier
1164449625
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DCP00500 Issued in RI
Practice address
1109 Atwells Ave
Providence, RI 02909-4144
Phone
(401) 569-9488
NPI assigned
Jul 17, 2006
Last updated
May 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DCP00500 RI Primary
Chiropractor 111N00000X 2915 MA
Chiropractor 111N00000X X010778-1 NY

Addresses

Primary practice location

1109 Atwells Ave
Providence, RI 02909-4144

Mailing address

1109 Atwells Ave
Providence, RI 02909-4144
Phone (401) 569-9488

Other identifiers 3

IdentifierTypeStateIssuer
31387OtherRIBCBSRI
412382OtherRIBLUE CHIP
670397OtherRIUNITEDHEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X010778-1NYMDChiropractor
2915MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care Centers, Inc Past Accepting new patients
Chiropractic Care Center, LLC Chiropractor Past Accepting new patients
Hyde Park Choice Chiropractic Inc Chiropractor Past Accepting new patients
PTW and CVD Enterprises LLC Chiropractor Past Accepting new patients

Organizations & group practices 4

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1164449625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 ATWELLS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029094144",
            "telephone_number": "401-569-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 ATWELLS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029094144",
            "telephone_number": "401-569-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "PHILLIP",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "RI",
            "license": "DCP00500",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2915",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010778-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSRI",
            "identifier": "31387",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "412382",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "670397",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.