Individual provider Active NPI

Judd Wattenbarger, D.C.

  • Chiropractor
  • Anchorage, AK
National Provider Identifier
1336153568
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
542 Issued in AK
Practice address
2011 Abbott Rd Ste C
Anchorage, AK 99507-3422
Phone
(303) 995-1622
Fax
(907) 345-7546
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5785 CO
Chiropractor 111N00000X 542 AK Primary

Addresses

Primary practice location

2011 Abbott Rd Ste C
Anchorage, AK 99507-3422

Mailing address

2011 Abbott Rd Ste C
Anchorage, AK 99507-3422
Phone (303) 995-1622

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

LicenseStateTypeSpecialty
5785COMDMental Health Counselor
542AKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Vitae LLC Chiropractor Current Accepting new patients
Cotter Family Chiropractic, P.C. Chiropractor PastSince Feb 27, 2018 Accepting new patients

Locations

2011 Abbott Rd
Ste C
Anchorage, AK 99507
Phone (303) 995-1622

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1336153568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 ABBOTT RD STE C",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995073422",
            "telephone_number": "303-995-1622",
            "fax_number": "907-345-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 ABBOTT RD STE C",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995073422",
            "telephone_number": "303-995-1622",
            "fax_number": "907-345-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTENBARGER",
        "first_name": "JUDD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5785",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.