Active NPI
Michael R Wild, D.C.
- Chiropractor
- Richmond, VA
National Provider Identifier
1477623858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0104001090
- Practice address
- 3460 Lauderdale Dr
Richmond, VA 23233-7529 - Phone
- (804) 360-2273
- Fax
- (804) 360-7996
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0104001090 | VA | Primary |
Addresses
Primary practice location
3460 Lauderdale Dr
Richmond, VA 23233-7529
Mailing address
3460 Lauderdale Dr
Richmond, VA 23233-7529
Phone (804) 360-2273
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54 1910925 | Other | VA | TAX ID |
| 181767 | Other | VA | BCBS |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Michael Wild LLC | Chiropractor | Current | Accepting new patients |
| Central Virginia Disc Center | Chiropractor | Past | Accepting new patients |
| Richmond Chiropractic Center, LLC | Chiropractor | Past | Accepting new patients |
| Dr. Will McGhee PLLC | Chiropractor | Past | Accepting new patients |
| West End Chiropractic Care, Inc. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Chiropractor
- Richmond, VA
- NPI 1306913025
-
- Chiropractor
- Glen Allen, VA
- NPI 1710019070
-
- Chiropractor
- Glen Allen, VA
- NPI 1689885808
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213833600000",
"number": "1477623858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3460 LAUDERDALE DR",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232337529",
"telephone_number": "804-360-2273",
"fax_number": "804-360-7996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3460 LAUDERDALE DR",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232337529",
"telephone_number": "804-360-2273",
"fax_number": "804-360-7996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILD",
"first_name": "MICHAEL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2008-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "VA",
"license": "0104001090",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "54 1910925",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "181767",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.