NPIMap

Organization Active NPI

Wagner Family Chiropractic PC

  • Chiropractor
  • Tulsa, OK
National Provider Identifier
1457495392
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3225 Issued in OK
Legal business name
WAGNER FAMILY CHIROPRACTIC PC
Practice address
3023 S Harvard Ave
Suite B
Tulsa, OK 74114-6139
Phone
(918) 742-2094
Fax
(918) 742-2095
NPI assigned
Feb 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Timothy A Wagner, DCNPI 1881644292
Title
Owner
Phone
(918) 742-2094

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3225 OK Primary

Addresses

Primary practice location

3023 S Harvard Ave
Suite B
Tulsa, OK 74114-6139

Mailing address

3023 S Harvard Ave
Suite B
Tulsa, OK 74114-6139
Phone (918) 742-2094

National Provider Directory

National Provider Directory

Locations

3023 S Harvard Ave
Ste B
Tulsa, OK 74114
Phone (718) 742-2094

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457495392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 S HARVARD AVE",
            "address_2": "SUITE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741146139",
            "telephone_number": "918-742-2094",
            "fax_number": "918-742-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 S HARVARD AVE",
            "address_2": "SUITE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741146139",
            "telephone_number": "918-742-2094",
            "fax_number": "918-742-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER FAMILY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-742-2094",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.