Patrick John Wagener, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5620-12 Issued in WI

Practice address

409 E Milwaukee St
Janesville, WI 53545-3184

Phone

(608) 754-3192

NPI assigned

Feb 17, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Douglas and Mork Chiropractic S CGroup PAC ID 9638265101, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Douglas & Mork Chiropractic S C

  • Chiropractor
  • Janesville, WI
  • NPI 1659432821
  Medicare reassignment Care Compare group
• Optima Health & Vitality Center

  • Chiropractor
  • Eau Claire, WI
  • NPI 1952501520
  Medicare reassignment NPD

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1285227645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 E MILWAUKEE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453184",
            "telephone_number": "608-754-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E MILWAUKEE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453184",
            "telephone_number": "608-754-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGENER",
        "first_name": "PATRICK",
        "middle_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5620-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• W Gilmore DDS SC (Gilmore Dental Group)
• Shelbria Leigh-Anne Wachtveitl, MSW, APSW, LCSW
• Dorothy Renee Waddell, PTA
• Treashure Wade, PHARM.D.
• John Patrick Wagener, DC
• Richard K Wagner, MD
• David J. Wakely, PH.D.
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1305)
• Wal-Mart Stores East, LP (Vision Center 30-1305)
• Denise Sue Walder, OT

• Chiropractor in Janesville, WI
• Providers in Janesville, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.