Individual provider Active NPI

Brian M Wildemuth, D.C.

  • Chiropractor
  • Santa Clarita, CA
National Provider Identifier
1457436313
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-26824 Issued in CA
Practice address
26850 Sierra Hwy
Ste a-14
Santa Clarita, CA 91321-2254
Phone
(661) 299-4933
Fax
(661) 299-4664
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-26824 CA Primary

Addresses

Primary practice location

26850 Sierra Hwy
Ste a-14
Santa Clarita, CA 91321-2254

Mailing address

26850 Sierra Hwy
Ste a-14
Santa Clarita, CA 91321-2254
Phone (661) 299-4933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-26824CAMDChiropractor
26824CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert L. Fisher Chiropractic, Inc. Chiropractor PastSince Oct 18, 2010 Accepting new patients

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1457436313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 SIERRA HWY",
            "address_2": "STE A-14",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212254",
            "telephone_number": "661-299-4933",
            "fax_number": "661-299-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 SIERRA HWY",
            "address_2": "STE A-14",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212254",
            "telephone_number": "661-299-4933",
            "fax_number": "661-299-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDEMUTH",
        "first_name": "BRIAN",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-26824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.