Individual provider Active NPI

Wilson S Wang, D.C.

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1265648778
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034666 Issued in WA
Practice address
509 Olive Way
1645
Seattle, WA 98101-1720
Phone
(206) 682-4424
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 010235 NY
Chiropractor 111N00000X CH00034666 WA Primary

Addresses

Primary practice location

509 Olive Way
1645
Seattle, WA 98101-1720

Mailing address

509 Olive Way
1645
Seattle, WA 98101-1720
Phone (206) 682-4424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080916000089 WA Practitioner - Chiropractic 3577649516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

509 Olive Way
Suite 1645
Seattle, WA 98101-1721
Phone (206) 682-4424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034666WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
City Chiropractic Inc Chiropractor CurrentSince Jun 1, 2008 Accepting new patients
Premier Diabetes Care, PLLC Past Accepting new patients

Locations

509 Olive Way
Ste 1645
Seattle, WA 98101
Phone (206) 226-4466

Organizations & group practices 2

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1265648778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "1645",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011720",
            "telephone_number": "206-682-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "1645",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011720",
            "telephone_number": "206-682-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "WILSON",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "010235",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.