Collision Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

COLLISION CHIROPRACTIC LLC

Practice address

11 W Van Buren St
Avondale, AZ 85323-1313

Phone

(480) 343-0585

NPI assigned

Mar 10, 2025

Last updated

Mar 10, 2025By 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

Gary L WagonerNPI 1932282878

Title

Manager

Phone

(480) 343-0585

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Gary L Wagoner, D.C.

  • Occupational Health Chiropractor
  • Mesa, AZ
  • NPI 1932282878
  Authorized official Same address or phone

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1396544888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16356 N THOMPSON PEAK PKWY APT 1089",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602103",
            "telephone_number": "480-343-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W VAN BUREN ST",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853231313",
            "telephone_number": "480-343-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLISION CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-09",
        "status": "A",
        "authorized_official_last_name": "WAGONER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-343-0585"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.