Organization Active NPI

Wiley Chiropractic Group P. C.

  • Chiropractor
  • Alamosa, CO
National Provider Identifier
1386962553
Registry record updated May 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1181 Issued in CO
Legal business name
WILEY CHIROPRACTIC GROUP P. C.
Practice address
511 Main St
Suite 6
Alamosa, CO 81101-2672
Phone
(719) 589-5163
Fax
(719) 589-8988
NPI assigned
May 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2010

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

Authorized official

Name
Dr. Terry L Wiley, DCNPI 1407956261
Title
President
Phone
(719) 589-5163

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 1181 CO Primary
Nutrition ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN1001X 1181 CO
Pediatric ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NP0017X 1181 CO
Radiology ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NR0200X 1181 CO
Rehabilitation ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NR0400X 1181 CO
Sports Physician ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NS0005X 1181 CO

Addresses

Primary practice location

511 Main St
Suite 6
Alamosa, CO 81101-2672

Mailing address

511 Main St
Suite 6
Alamosa, CO 81101-2672
Phone (719) 589-5163

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100628000156 CO Part B Supplier - Clinic/Group Practice 7012048598 Receives reassigned benefits from 1 practitioner
Practice locations: Alamosa, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2078454Wiley Chiropractic Group PC511 Main St, Ste 6, Alamosa, CO 81101Certificate of waiverMay 28, 2028

National Provider Directory

National Provider Directory

Locations

511 Main St
Ste 6
Alamosa, CO 81101
Phone (719) 589-5163

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273622400000",
    "number": "1386962553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MAIN ST",
            "address_2": "SUITE 6",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012672",
            "telephone_number": "719-589-5163",
            "fax_number": "719-589-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MAIN ST",
            "address_2": "SUITE 6",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012672",
            "telephone_number": "719-589-5163",
            "fax_number": "719-589-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILEY CHIROPRACTIC GROUP P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-12",
        "last_updated": "2010-05-12",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-589-5163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "1181",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "CO",
            "license": "1181",
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "CO",
            "license": "1181",
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Radiology",
            "state": "CO",
            "license": "1181",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CO",
            "license": "1181",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "CO",
            "license": "1181",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamosa, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; 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.