Barry A Wahner, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC004737L Issued in PA

Practice address

4931 Wissahickon Ave
1St Floor
Philadelphia, PA 19144-4800

Phone

(215) 842-2227

Fax

(215) 842-2229

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1215962774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4931 WISSAHICKON AVE",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444800",
            "telephone_number": "215-842-2227",
            "fax_number": "215-842-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4931 WISSAHICKON AVE",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444800",
            "telephone_number": "215-842-2227",
            "fax_number": "215-842-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHNER",
        "first_name": "BARRY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC004737L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "0526039000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1296428",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.