Active NPI
Richard Grover Wilson, D.C.
- Chiropractor
- Waco, TX
National Provider Identifier
1194015925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6186
- Practice address
- 708 Lake Air Dr
Waco, TX 76710-5772 - Phone
- (254) 741-6122
- NPI assigned
- Apr 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6186 | TX | Primary |
Addresses
Primary practice location
708 Lake Air Dr
Waco, TX 76710-5772
Mailing address
708 Lake Air Dr
Waco, TX 76710-5772
Phone (254) 741-6122
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6186 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302652800000",
"number": "1194015925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 LAKE AIR DR",
"city": "WACO",
"state": "TX",
"postal_code": "767105772",
"telephone_number": "254-741-6122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 LAKE AIR DR",
"city": "WACO",
"state": "TX",
"postal_code": "767105772",
"telephone_number": "254-741-6122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "RICHARD",
"middle_name": "GROVER",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-13",
"last_updated": "2011-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "6186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.