Widmaier Chiropractic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4220 Issued in AZ

Legal business name

WIDMAIER CHIROPRACTIC

Practice address

5080 N 40TH St Ste 104
Phoenix, AZ 85018-2158

Phone

(602) 954-6200

Fax

(602) 956-1582

NPI assigned

Sep 26, 2012

Organization subpart

No

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

Authorized official

Name

Randall S Widmaier, DCNPI 1770548554

Title

President

Phone

(602) 954-6200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

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

• Randall Scott Widmaier, DC

  • Chiropractor
  • Phoenix, AZ
  • NPI 1770548554
  Medicare reassignment NPD Authorized official
• Richard James Chamberlain III, M.D.

  • Surgery Physician
  • Phoenix, AZ
  • NPI 1487614277
  NPD (past)

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1205187689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 N 40TH ST STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182158",
            "telephone_number": "602-954-6200",
            "fax_number": "602-956-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 N 40TH ST STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182158",
            "telephone_number": "602-954-6200",
            "fax_number": "602-956-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIDMAIER CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-26",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "WIDMAIER",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-954-6200",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "4220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skylar Ann Wickman
• Laura Wicks, PHARMD
• Victoria Wicus, MOT OTR/L, BCP, CIMI
• Brittany Widdowson, PT, DPT
• Marissa Ann Widener, LPC
• Randall Scott Widmaier, DC
• Courtney Widmer
• Michael Blaine Widmer, DO
• Dayna Alison Widoff, M.S.
• Christopher Sung Wie, MD

• Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.