Organization Active NPI

Wishmyer Chiropractic and Wellness, Professional Corporation

  • Chiropractor
  • Newport Beach, CA
National Provider Identifier
1336951045
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WISHMYER CHIROPRACTIC AND WELLNESS, PROFESSIONAL CORPORATION
Practice address
2095 San Joaquin Hills Rd
Newport Beach, CA 92660-6505
Phone
(949) 500-2875
Fax
(949) 945-0232
NPI assigned
Jan 21, 2025
Last updated
Jan 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Dr. Jordan Wishmyer, DCNPI 1649638321
Title
Owner
Phone
(949) 500-2875

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

2095 San Joaquin Hills Rd
Newport Beach, CA 92660-6505

Mailing address

2095 San Joaquin Hills Rd
Newport Beach, CA 92660-6505
Phone (949) 500-2875

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250702003848 CA Part B Supplier - Clinic/Group Practice 4688187560 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

Locations

2095 San Joaquin Hills Rd
Newport Beach, CA 92660
Phone (949) 500-2875

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1336951045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 SAN JOAQUIN HILLS RD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606505",
            "telephone_number": "949-500-2875",
            "fax_number": "949-945-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 SAN JOAQUIN HILLS RD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606505",
            "telephone_number": "949-500-2875",
            "fax_number": "949-945-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISHMYER CHIROPRACTIC AND WELLNESS, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "WISHMYER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-500-2875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.