Wildcat Chiropractic Sports & Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4457 Issued in KS

Legal business name

WILDCAT CHIROPRACTIC SPORTS & WELLNESS CENTER LLC

Practice address

503 E. Bertrand Ave
St Marys, KS 66536

Phone

(785) 437-6162

Fax

(785) 437-6197

NPI assigned

Aug 16, 2006

Last updated

Jan 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gary E Cleveland, DC CCEP CCSPNPI 1023121100

Title

President

Phone

(785) 323-1923

Specialties & licenses 1

Addresses

Other names 1

• Wildcat Sports & Family Clinic Former legal business name

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

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.

• Gary E Cleveland, DC CCEP CCSP

  • Chiropractor
  • Manhattan, KS
  • NPI 1023121100
  Medicare reassignment Authorized official
• Kimra S Qualls, D.C.

  • Chiropractor
  • Saint Marys, KS
  • NPI 1487752788
  NPD (past)
• Patrick D Qualls, D.C.

  • Chiropractor
  • Saint Marys, KS
  • NPI 1851499156
  NPD (past)
• Forrest Wayne Saxon, DC

  • Chiropractor
  • Ulysses, KS
  • NPI 1720127251
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1275646382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E. BERTRAND AVE",
            "city": "ST MARYS",
            "state": "KS",
            "postal_code": "66536",
            "telephone_number": "785-437-6162",
            "fax_number": "785-437-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E. BERTRAND AVE",
            "city": "ST MARYS",
            "state": "KS",
            "postal_code": "66536",
            "telephone_number": "785-437-6162",
            "fax_number": "785-437-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDCAT CHIROPRACTIC SPORTS & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "CLEVELAND",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-323-1923",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC CCEP CCSP"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "4457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wildcat Sports & Family Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Matthew C Ridder, ARNP
• Tara Roberts
• Thomas Seiter, MD
• Valerie Catherine Shaw
• St Marys Family Practice, PA

• Chiropractor in Saint Marys, KS
• Providers in Saint Marys, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.