Wagner Family Chiropractic Clinic Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

AO5587 Issued in IA

Legal business name

WAGNER FAMILY CHIROPRACTIC CLINIC INC.

Practice address

8553 Hickman Rd
Urbandale, IA 50322-4321

Phone

(515) 270-5868

Fax

(515) 270-5878

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael E Wagner, D.C.NPI 1083719942

Title

Director

Phone

(515) 270-5868

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael E Wagner, D.C.

  • Chiropractor
  • Urbandale, IA
  • NPI 1083719942
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1376664995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8553 HICKMAN RD",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224321",
            "telephone_number": "515-270-5868",
            "fax_number": "515-270-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8553 HICKMAN RD",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224321",
            "telephone_number": "515-270-5868",
            "fax_number": "515-270-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER FAMILY CHIROPRACTIC CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "515-270-5868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "AO5587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076968",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Voogd, CADCV
• Kassandra Wabshaw
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• Wadle & Associates PC
• Charles Vincent Wadle, D.O.
• Michael E Wagner, D.C.
• Lisa Waknitz
• Michele Grace Wald, LMSW
• Walgreen Co
• Walgreen Co

• Chiropractor in Urbandale, IA
• Providers in Urbandale, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.