Wagner Chiropractic, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

061 Issued in ND

Legal business name

WAGNER CHIROPRACTIC, PC

Practice address

1431 Interstate Loop
Bismarck, ND 58503-0510

Phone

(701) 223-5001

Fax

(701) 223-4709

NPI assigned

Feb 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Barry D Wagner, DCNPI 1437235934

Title

Owner/President

Phone

(701) 223-5001

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Practitioners 1

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

• Barry D Wagner, DC

  • Chiropractor
  • Bismarck, ND
  • NPI 1437235934
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293753600000",
    "number": "1649502212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 INTERSTATE LOOP",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030510",
            "telephone_number": "701-223-5001",
            "fax_number": "701-223-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 INTERSTATE LOOP",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030510",
            "telephone_number": "701-223-5001",
            "fax_number": "701-223-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-12-31",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "701-223-5001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17241",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NORTH DAKOTA",
            "identifier": "19785",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U32827",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4404746",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "667437",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle R Vorachek
• Elida Rose Voth, MD
• Rachel Voyles
• Carly Vraa
• W G Paape
• Ashley Lynn Wagner, D.C.
• Barry D Wagner, DC
• Faith M Wagner, FNP-C
• Michelle Wagner, RD,LRD
• Scott Allen Wagner, MSOTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2010; 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.