Peter J Wakeman, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH5831 Issued in FL

Practice address

305 Memorial Medical Pkwy Ste 305
Daytona Beach, FL 32117-5169

Phone

(386) 673-0201

Fax

(386) 677-8143

NPI assigned

Dec 21, 2005

Last updated

Apr 3, 2018By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wakeman Chiropractic , PA

  dba Wakeman Chiropractic

  • Chiropractor
  • Daytona Beach, FL
  • NPI 1245318492
  Medicare reassignment NPD Authorized official
• Complete Wellness Chiropractic Center of Deland LLC

  dba Complete Wellness Medical Center

  • Orthopedic Chiropractor
  • Deland, FL
  • NPI 1134249618
  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1669458600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 305",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175169",
            "telephone_number": "386-673-0201",
            "fax_number": "386-677-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 305",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175169",
            "telephone_number": "386-673-0201",
            "fax_number": "386-677-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEMAN",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "22266",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00103322",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050602800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nashwa Marie Wahba, DO
• Wahba W Wahba, MD
• Mary Callahan Waikins, LCSW
• Karl Ellsworth Waite, MD
• Wakeman Chiropractic , PA (Wakeman Chiropractic)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3862)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1391)
• Wal-Mart Stores East, LP (Vision Center 30-1391)
• Natassia Monique Walburg, AGPCNP-BC, APRN, MSN
• Walgreen Co (Walgreens #05584)

• Chiropractor in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.