Andrew Mark Wagner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

809 Issued in ND

Practice address

4357 13TH Ave S
Suite 100
Fargo, ND 58103-3381

Phone

(701) 269-3219

NPI assigned

Jan 28, 2008

Last updated

Jan 28, 2008By the provider in NPPES

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

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.

• Andrew Wagner Chiropractic LLC

  • Chiropractor
  • Fargo, ND
  • NPI 1457520124
  Authorized official Same address or phone

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1629255047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 42ND ST S",
            "address_2": "APARTMENT 106",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046959",
            "telephone_number": "701-269-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4357 13TH AVE S",
            "address_2": "SUITE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033381",
            "telephone_number": "701-269-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ANDREW",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle A Wadeson
• Shelly Wadhawan, MD
• Mary Jo Hage Wagar, PT
• Leann A Wages, CNS
• Abigail Wagner
• Angela D Wagner, PA-C
• Meredith G Wagner, LRD
• Stacey Lynn Wagner, LSW
• Tyler Wagner, PMHNP-BC
• Haley Faye Wahl

• Chiropractor in Fargo, ND
• Providers in Fargo, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.