John S Wagner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08000532A Issued in IN

Practice address

3778 Union St
Lafayette, IN 47905-4453

Phone

(765) 448-1674

NPI assigned

Nov 9, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1976

Medicare assignment

May accept Medicare assignment

Group practices

Lafayette Chiropractic LLCGroup PAC ID 5193193852, 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.

• Lafayette Chiropractic LLC

  • Chiropractor
  • Lafayette, IN
  • NPI 1942479423
  Medicare reassignment Care Compare group
• Lafayette Chiropractic LLC

  • Chiropractor
  • Lafayette, IN
  • NPI 1912622093
  NPD

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1346221041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3778 UNION ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054453",
            "telephone_number": "765-448-1674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3778 UNION ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054453",
            "telephone_number": "765-448-1674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08000532A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000197485",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100262580",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wabash Center, Inc.
• Wabash Center, Inc.
• Wabash Center, Inc.
• Jacob Wade, NP
• Brandon James Wagner, DC
• Julia Marie Wagner, D.C.
• Theodore T Wagner III, MD
• Britney Wagoner
• Elizabeth Wagoner
• John E Wagoner, MD

• Chiropractor in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.