Individual provider Active NPI

Randall Wade Wilds, DC

  • Chiropractor
  • Haines City, FL
National Provider Identifier
1205949765
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7897 Issued in TX
Practice address
103 S Dixie Dr
Haines City, FL 33844-2844
Phone
(214) 537-1565
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7897 TX Primary

Addresses

Primary practice location

103 S Dixie Dr
Haines City, FL 33844-2844

Mailing address

103 S Dixie Dr
Haines City, FL 33844-2844
Phone (214) 537-1565

Other identifiers 1

IdentifierTypeStateIssuer
8G2628OtherTXBLUE CROSS BLUE SHIELD TX

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

LicenseStateTypeSpecialty
7897TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
27 Injury & Wellness, LLC Current Accepting new patients

Locations

103 S Dixie Dr
Haines City, FL 33844
Phone (214) 537-1565

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1205949765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S DIXIE DR",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338442844",
            "telephone_number": "214-537-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S DIXIE DR",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338442844",
            "telephone_number": "214-537-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDS",
        "first_name": "RANDALL",
        "middle_name": "WADE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "7897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "8G2628",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.