Organization Active NPI

Wiederrich Chiropractic Clinic, Apc

  • Chiropractor
  • Poway, CA
National Provider Identifier
1215098793
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC23611 Issued in CA
Legal business name
WIEDERRICH CHIROPRACTIC CLINIC, APC
Practice address
14103 Poway Road
Poway, CA 92064
Phone
(858) 748-4343
Fax
(858) 748-4881
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Authorized official

Name
Hans Orrin Wiederrich, D.C.NPI 1861552499
Title
President
Phone
(858) 748-4343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC23611 CA Primary

Addresses

Primary practice location

14103 Poway Road
Poway, CA 92064

Mailing address

14103 Poway Road
Poway, CA 92064
Phone (858) 748-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050321000910 CA Part B Supplier - Clinic/Group Practice 7315992500 Receives reassigned benefits from 1 practitioner
Practice locations: Poway, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1215098793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14103 POWAY ROAD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-748-4343",
            "fax_number": "858-748-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14103 POWAY ROAD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-748-4343",
            "fax_number": "858-748-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIEDERRICH CHIROPRACTIC CLINIC, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "WIEDERRICH",
        "authorized_official_first_name": "HANS",
        "authorized_official_middle_name": "ORRIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-748-4343",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.