Individual provider Active NPI

Michael John Wenstrup, DC

  • Chiropractor
  • Gilbert, AZ
National Provider Identifier
1457985459
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8904 Issued in AZ
Practice address
745 S Val Vista Dr Ste 105
Gilbert, AZ 85296-3131
Phone
(480) 497-2900
NPI assigned
Feb 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 8904 AZ Primary

Addresses

Primary practice location

745 S Val Vista Dr Ste 105
Gilbert, AZ 85296-3131

Mailing address

3301 E Angela Dr
Phoenix, AZ 85032-2097
Phone (480) 747-7486

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8904AZMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1457985459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 E ANGELA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322097",
            "telephone_number": "480-747-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 S VAL VISTA DR STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963131",
            "telephone_number": "480-497-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENSTRUP",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.