Active NPI
Wilson Family Chiropractic Center Inc.
- Chiropractor
- Waterloo, IA
National Provider Identifier
1508819038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 06870
- Legal business name
- WILSON FAMILY CHIROPRACTIC CENTER INC.
- Practice address
- 751 Progress Ave
Waterloo, IA 50701-3108 - Phone
- (319) 232-5366
- Fax
- (319) 232-5370
- NPI assigned
- May 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Zachary Paul Wilson, D.C.
- Title
- Doctor / Owner
- Phone
- (319) 232-5366
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 06870 | IA | Primary |
Addresses
Primary practice location
751 Progress Ave
Waterloo, IA 50701-3108
Mailing address
751 Progress Ave
Waterloo, IA 50701-3108
Phone (319) 232-5366
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0485664 | Medicaid | IA | |
| 0485672 | Medicaid | IA |
National Provider Directory
National Provider DirectoryLocations
751 Progress Ave
Waterloo, IA 50701
Phone (319) 232-5356
1911 Schukei Rd
Waterloo, IA 50702
Phone (319) 232-5356
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Carroll, IA
- NPI 1669439022
-
- Chiropractor
- Davenport, IA
- NPI 1144230376
-
- Chiropractor
- Janesville, IA
- NPI 1891865788
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1339459200000",
"number": "1508819038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "751 PROGRESS AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507013108",
"telephone_number": "319-232-5366",
"fax_number": "319-232-5370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 PROGRESS AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507013108",
"telephone_number": "319-232-5366",
"fax_number": "319-232-5370"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILSON FAMILY CHIROPRACTIC CENTER INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2012-06-12",
"status": "A",
"authorized_official_last_name": "WILSON",
"authorized_official_first_name": "ZACHARY",
"authorized_official_middle_name": "PAUL",
"authorized_official_title_or_position": "DOCTOR / OWNER",
"authorized_official_telephone_number": "319-232-5366",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "IA",
"license": "06870",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0485664",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0485672",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.