Wacker Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3695-012 Issued in WI

Legal business name

WACKER CHIROPRACTIC, LLC

Practice address

430 W Union St Ste 2
Richland Center, WI 53581-2220

Phone

(608) 647-9100

Fax

(608) 647-9001

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Daryl R Wacker, D.C.NPI 1861418816

Title

Owner

Phone

(608) 647-9100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daryl Wacker, D.C.

  • Chiropractor
  • Richland Center, WI
  • NPI 1861418816
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1487795084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 E MILL ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535812241",
            "telephone_number": "608-647-9100",
            "fax_number": "608-647-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W UNION ST STE 2",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535812220",
            "telephone_number": "608-647-9100",
            "fax_number": "608-647-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACKER CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "WACKER",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-647-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3695-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Richland Center, WI
• Providers in Richland Center, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.