Individual provider Active NPI

Terry L. Wiley, D.C.

  • Nutrition Chiropractor
  • Alamosa, CO
National Provider Identifier
1407956261
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
1181 Issued in CO
Practice address
511 Main St., Suite #6
Alamosa, CO 81101-2664
Phone
(719) 589-5163
Fax
(719) 589-8988
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 1181 CO Primary

Addresses

Primary practice location

511 Main St., Suite #6
Alamosa, CO 81101-2664

Mailing address

511 Main St Ste 6
Alamosa, CO 81101-2649
Phone (719) 589-5163

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041015000448 CO Practitioner - Chiropractic 4183684962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

511 Main St
Suite 6
Alamosa, CO 81101-2649
Phone (719) 589-5163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1181COMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Wiley Chiropractic Group P. C. Nutrition CurrentSince May 21, 2010 Accepting new patients

Locations

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

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1407956261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MAIN ST STE 6",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012649",
            "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., SUITE #6",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012664",
            "telephone_number": "719-589-5163",
            "fax_number": "719-589-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "TERRY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CO",
            "license": "1181",
            "primary": true
        }
    ],
    "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 Oct 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.