R Eilleen Decena Wilbert, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

01-05015 Issued in KS

Practice address

2434 N Woodlawn Blvd
Ste. # 170
Wichita, KS 67220-3997

Phone

(316) 683-5490

Fax

(316) 683-0630

NPI assigned

Sep 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1376649699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 N WOODLAWN ST",
            "address_2": "STE. # 170",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203959",
            "telephone_number": "316-683-5490",
            "fax_number": "316-683-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 N WOODLAWN BLVD",
            "address_2": "STE. # 170",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203997",
            "telephone_number": "316-683-5490",
            "fax_number": "316-683-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBERT",
        "first_name": "R EILLEEN",
        "middle_name": "DECENA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "16-1745407",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Wichita, KS
• Providers in Wichita, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.