Wilson Chiropractic Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104001092 Issued in VA

Legal business name

WILSON CHIROPRACTIC CLINIC

Doing business as

Brambleton Commons Chiropractic

Practice address

3390 Colonial Ave
Roanoke, VA 24018

Phone

(540) 776-0101

Fax

(540) 776-7873

NPI assigned

Dec 6, 2006

Organization subpart

Yes

Parent organization

DR HOWARD K WILSONAs reported in NPPES

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

Authorized official

Name

Dr. Howard Kendall Wilson, D.C.NPI 1316911753

Title

President

Phone

(540) 776-0101

Specialties & licenses 1

Addresses

Other names 2

• Brambleton Commons Chiropractic Doing business as
• Wilson Chiropractic Clinic Former legal business name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Part of

Wilson Chiropractic Clinic

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Howard Kendall Wilson, DC

  • Chiropractor
  • Roanoke, VA
  • NPI 1316911753
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1275692386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20382",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180039",
            "telephone_number": "540-776-0101",
            "fax_number": "540-776-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 COLONIAL AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24018",
            "telephone_number": "540-776-0101",
            "fax_number": "540-776-7873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4521 Brambleton Avenue",
            "address_2": "Suite 206",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240183436",
            "country_code": "US",
            "telephone_number": "540-776-0101",
            "fax_number": "540-776-7873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILSON CHIROPRACTIC CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR HOWARD K WILSON",
        "enumeration_date": "2006-12-06",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "KENDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-776-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brambleton Commons Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brambleton Commons Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wilson Chiropractic Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Charles J Wills, LPC
• Gabrielle Evelyn Willson
• Timothy R Willson, D.C.
• Tyler Davis Willson
• Claire Wilsey, PA
• Adrian Shawn Reid Wilson, PHARMD
• Andrew Michael Wilson, PTA
• Autumn Simms Wilson, LPC
• Caitlin Ann Wilson, DO
• Cedric Wilson

• Chiropractor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.