Andrew Wagner, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2022001832 Issued in MO

Practice address

2601 NE Kendallwood Pkwy Ste 101
Gladstone, MO 64119-2171

Phone

(816) 868-3680

NPI assigned

Feb 8, 2022

Last updated

Feb 8, 2022By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Wagner Chiropractics LLC

  • Chiropractor
  • Gladstone, MO
  • NPI 1609520774
  Authorized official Same address or phone

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1518611672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19803 NE 102ND ST",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640688735",
            "telephone_number": "816-868-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 NE KENDALLWOOD PKWY STE 101",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641192171",
            "telephone_number": "816-868-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ANDREW",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2022001832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Gladstone",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2601 NE Kendallwood Pkwy Ste 101",
            "city": "Gladstone",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641192171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Viking Vision, Inc. (In Vision Eye Care Center Gladstone)
• Amanda Kathryn Voigt, PHARMD
• Elizabeth Anne Wachira, PHARMD
• James Steven Waddell, DC
• Wagner Chiropractics LLC
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1120)
• Wal-Mart Stores East, LP (Vision Center 30-1120)
• Austin Walker, PHARMD
• Gerald E Walton, D.D.S.
• Daniel C Wenzel

• Chiropractor in Gladstone, MO
• Providers in Gladstone, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.