Richard Allen Wildermuth, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR011200 Issued in GA

Practice address

120 Hickory Flat Hwy
Holly Springs, GA 30114

Phone

(678) 880-6616

NPI assigned

Dec 12, 2024

Last updated

Dec 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Chiropractic and Massage PCGroup PAC ID 7810375383, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Chiropractic and Massage, PC

  • Chiropractor
  • Holly Springs, GA
  • NPI 1023764172
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1487461547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HICKORY FLAT HWY",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "678-880-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HICKORY FLAT HWY",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "678-880-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDERMUTH",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR011200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• April J West
• Kendall Williams
• Willow & Moss Counseling LLC
• Willow & Moss Counseling Services LLC
• Monika S Yadav, M.D.
• Jennifer Yam, MD

• Chiropractor in Holly Springs, GA
• Providers in Holly Springs, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.