Organization Active NPI

Waukee Wellness & Chiropractic, PC

  • Chiropractor
  • Waukee, IA
National Provider Identifier
1225207939
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06841 Issued in IA
Legal business name
WAUKEE WELLNESS & CHIROPRACTIC, PC
Practice address
710 Alices Rd
Waukee, IA 50263-9646
Phone
(515) 978-6661
Fax
(515) 978-6662
NPI assigned
Feb 27, 2008
Last updated
Feb 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Dr. Wesley James Nyberg, D.C.NPI 1194814855
Title
President
Phone
(515) 978-6661

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
Chiropractor 111N00000X 06841 IA Primary

Addresses

Primary practice location

710 Alices Rd
Waukee, IA 50263-9646

Mailing address

710 Alices Rd
Waukee, IA 50263-9646
Phone (515) 978-6661

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080417000098 IA Part B Supplier - Clinic/Group Practice 3072691955 Receives reassigned benefits from 2 practitioners
Practice locations: Waukee, IA

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1225207939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 ALICES RD",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502639646",
            "telephone_number": "515-978-6661",
            "fax_number": "515-978-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 ALICES RD",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502639646",
            "telephone_number": "515-978-6661",
            "fax_number": "515-978-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKEE WELLNESS & CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "NYBERG",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-978-6661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukee, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.