Active NPI
Brian K Wagoner, D.C.
- Chiropractor
- Perrysburg, OH
National Provider Identifier
1235213976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3177
- Practice address
- 25139 Ella St
Perrysburg, OH 43551-9684 - Phone
- (419) 837-6213
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3177 | OH | Primary |
Addresses
Primary practice location
25139 Ella St
Perrysburg, OH 43551-9684
Mailing address
25139 Ella St
Perrysburg, OH 43551-9684
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fallen Timbers Chiropractic, LLC | Past | Accepting new patients |
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.
-
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247356800000",
"number": "1235213976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25139 ELLA ST",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435519684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25139 ELLA ST",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435519684",
"telephone_number": "419-837-6213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGONER",
"first_name": "BRIAN",
"middle_name": "K",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2009-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "3177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perrysburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.