Shannon R. Wyman, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0408 Issued in AK

Practice address

515 7TH Ave Ste 230
Fairbanks, AK 99701-4949

Phone

(907) 456-4234

Fax

(907) 451-9168

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Spaulding Chiropractic Clinic IncGroup PAC ID 1658263413, 4 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 and National Provider Directory roles.

• Spaulding Chiropractic Clinic Inc

  • Chiropractor
  • Fairbanks, AK
  • NPI 1437273125
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1629125356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 7TH AVE STE 230",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014949",
            "telephone_number": "907-456-4234",
            "fax_number": "907-451-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 7TH AVE STE 230",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014949",
            "telephone_number": "907-456-4234",
            "fax_number": "907-451-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "SHANNON",
        "middle_name": "R.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "0408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH0408",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004390",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bovey Jingzhu Wu, DO
• Glenn Eduard Christiane Wuyts
• WW Enterprise, LLC
• Monica Wyatt, RN
• Kenneth W Wyman II
• Brian Edward Yamamoto, DDS
• Leslie Yamamoto, LCSW
• Fusheng Jonathan Yang
• Brionna Leigh Yannello
• Kristina Yates

• Chiropractor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Chiropractor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.