Individual provider Active NPI

Wayne Brooks Ladd, D.C.

  • Chiropractor
  • Kokomo, IN
National Provider Identifier
1386714293
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001690A Issued in IN
Practice address
2136 N Cooper St
Kokomo, IN 46901-1697
Phone
(765) 452-0888
Fax
(765) 452-6288
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001690A IN Primary

Addresses

Primary practice location

2136 N Cooper St
Kokomo, IN 46901-1697

Mailing address

2136 N Cooper St
Kokomo, IN 46901-1697
Phone (765) 452-0888

Other identifiers 1

IdentifierTypeStateIssuer
200412100AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110930000089 IN Practitioner - Chiropractic 8123923349

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2136 N Cooper St
Kokomo, IN 46901-1697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001690AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Chiropractic Center Inc Chiropractor CurrentSince Jul 18, 2003 Accepting new patients

Locations

1775 E Lincoln Rd
Kokomo, IN 46902
Phone (765) 450-8204

1719 Faith Rd
Kokomo, IN 46901
Phone (317) 452-0888

2136 N Cooper St
Kokomo, IN 46901
Phone (765) 452-0888

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1386714293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 N COOPER ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469011697",
            "telephone_number": "765-452-0888",
            "fax_number": "765-452-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2136 N COOPER ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469011697",
            "telephone_number": "765-452-0888",
            "fax_number": "765-452-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADD",
        "first_name": "WAYNE",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001690A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200412100A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.