Individual provider Active NPI

Austen Wisroth, D.C.

  • Chiropractor
  • Casper, WY
National Provider Identifier
1275999641
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
759 Issued in WY
Practice address
5880 E 2ND St Ste 200
Casper, WY 82609-4388
Phone
(307) 575-2448
NPI assigned
Jan 14, 2016
Last updated
Jan 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 759 WY Primary

Addresses

Primary practice location

5880 E 2ND St Ste 200
Casper, WY 82609-4388

Mailing address

5880 E 2ND St Ste 200
Casper, WY 82609-4388

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160427001877 WY Practitioner - Chiropractic 2769781673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2015
Medicare assignment
May accept Medicare assignment
Group practices
307 Chiropractic Health Center PCGroup PAC ID 1850690769, 3 clinicians

Practice addresses (Care Compare)

5980 Enterprise Dr
Casper, WY 82609-4207
Phone (307) 337-3303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
759WYMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
307 Chiropractic Health Center PC CurrentSince Mar 28, 2016 Accepting new patients

Locations

5880 E 2nd St
Ste 200
Casper, WY 82609
Phone (307) 337-3303

5980 Enterprise Dr
Casper, WY 82609
Phone (307) 337-3303

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1275999641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 E 2ND ST STE 200",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 E 2ND ST STE 200",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094388",
            "telephone_number": "307-575-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISROTH",
        "first_name": "AUSTEN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.