Wilde Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

290149-1202 Issued in UT

Legal business name

WILDE CHIROPRACTIC, LLC

Practice address

246 S 1100 E
American Fork, UT 84003-2829

Phone

(801) 756-8833

Fax

(801) 756-9014

NPI assigned

Aug 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Larry G Wilde, D.C.NPI 1770515934

Title

Owner

Phone

(801) 756-8833

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 3

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.

• Larry G Wilde, D.C.

  • Chiropractor
  • American Fork, UT
  • NPI 1770515934
  Medicare reassignment NPD Authorized official
• Greg William Kofford, D.C.

  • Chiropractor
  • American Fork, UT
  • NPI 1043307689
  NPD
• Joshua William Bryan, D.C.

  • Chiropractor
  • American Fork, UT
  • NPI 1124196167
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356454516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 S 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032829",
            "telephone_number": "801-756-8833",
            "fax_number": "801-756-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 S 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032829",
            "telephone_number": "801-756-8833",
            "fax_number": "801-756-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILDE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-756-8833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "290149-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cari Joyce Whitmore, DPT
• Frank M Whitney, RPH
• Christopher Jay Wilcox, PA
• Jeffrey Dallin Wilcox, M.D.
• Ryan B Wilcox, M.D.
• Larry G Wilde, D.C.
• Aaron Ezekiel Wilkerson, FNP-C
• Dalton Wilkes
• Phillip James Willard
• Jon Willardson

• Chiropractor in American Fork, UT
• Providers in American Fork, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.