Wagner Wellness LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

Legal business name

WAGNER WELLNESS LLC

Doing business as

Rehab Lab Wisconsin

Practice address

W3173 Springfield Dr
Appleton, WI 54915-6183

Phone

(920) 533-0771

NPI assigned

Oct 1, 2024

Last updated

Oct 1, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Wagner, DCNPI 1114695186

Title

Owner/Lead Doctor

Phone

(262) 344-1968

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Rehab Lab Wisconsin Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Wagner, DC

  • Chiropractor
  • Green Bay, WI
  • NPI 1114695186
  NPD Authorized official

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1205654068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3173 SPRINGFIELD DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549156183",
            "telephone_number": "920-533-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3173 SPRINGFIELD DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549156183",
            "telephone_number": "920-533-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER/LEAD DOCTOR",
        "authorized_official_telephone_number": "262-344-1968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HHS",
            "identifier": "1114695186",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HHS",
            "identifier": "1598371668",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehab Lab Wisconsin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael L Wage, MD, PHD
• Ann Wagener, DDS
• Christopher W Wagener, MD
• Wagner Family Chiropractic SC
• Wagner Family Chiropractic SC
• Christopher T Wagner, MD
• Courtney Lynn Wagner, LAT, ATC
• Jody Michelle Wagner, D.C.
• Kaelyn Wagner, DPT
• Keith Dineen Wagner, M.D.

• Rehabilitation Chiropractor in Appleton, WI
• Providers in Appleton, WI by specialty
• Rehabilitation Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.