Active NPI
William O. Wagnon, DC
- Sports Physician Chiropractor
- Woodland, CA
National Provider Identifier
1306877691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 14800
- Practice address
- 1319 College St
Woodland, CA 95695-4706 - Phone
- (530) 666-6662
- Fax
- (530) 666-6643
- NPI assigned
- Jul 5, 2006
- Last updated
- Jul 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 14800 | CA | Primary |
Addresses
Primary practice location
1319 College St
Woodland, CA 95695-4706
Mailing address
1319 College St
Woodland, CA 95695-4706
Phone (530) 666-6662
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14800 | CA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216080000000",
"number": "1306877691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1319 COLLEGE ST",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956954706",
"telephone_number": "530-666-6662",
"fax_number": "530-666-6643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 COLLEGE ST",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956954706",
"telephone_number": "530-666-6662",
"fax_number": "530-666-6643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNON",
"first_name": "WILLIAM",
"middle_name": "O.",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2008-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "CA",
"license": "14800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.