Adam Wagner

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6987 Issued in MN

Practice address

3400 1St St N Ste 105
Saint Cloud, MN 56303-1924

Phone

(320) 774-1355

NPI assigned

Jan 2, 2015

Last updated

Jul 22, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1477941151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 1ST ST N STE 105",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031924",
            "telephone_number": "320-774-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 1ST ST N STE 105",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031924",
            "telephone_number": "320-774-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-02",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6987",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "T530255488808",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tririna Vue
• Brittany Nicole Vyskocil, LPN
• Pam J. Waage, CPNP
• Donna Jane Wacker, LICSW
• Lydia M Wade, M.D.
• Londa Sinness Wagner, MS, LMFT, IMH-E
• Meah Wagoner
• Casandra Conlee Wahl, AUD
• Grace Wahl
• Robert Chris Waitt, MS LP

• Chiropractor in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.