NPIMap

Organization Active NPI

Jay J Fitzgerald DC

Doing business as Wagner Chiropractic Clinic

  • Chiropractor
  • Wagner, SD
National Provider Identifier
1689798092
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
840 Issued in SD
Legal business name
JAY J FITZGERALD DC
Doing business as
Wagner Chiropractic Clinic
Practice address
109 1St St. SW
Wagner, SD 57380-0758
Phone
(605) 384-5419
Fax
(605) 384-5410
NPI assigned
Mar 19, 2007
Last updated
Apr 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Authorized official

Name
Dr. Jay Joseph Fitzgerald, D.C.NPI 1447220603
Title
Owner
Phone
(605) 384-5419

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 840 SD Primary

Addresses

Primary practice location

109 1St St. SW
Wagner, SD 57380-0758

Mailing address

109 1St St. SW
P.O. Box 758
Wagner, SD 57380-0758
Phone (605) 384-5419

Other identifiers 1

IdentifierTypeStateIssuer
7604080MedicaidSD

Other names 1

  • Wagner Chiropractic Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1689798092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 1ST ST. SW",
            "address_2": "P.O. BOX 758",
            "city": "WAGNER",
            "state": "SD",
            "postal_code": "573800758",
            "telephone_number": "605-384-5419",
            "fax_number": "605-384-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 1ST ST. SW",
            "city": "WAGNER",
            "state": "SD",
            "postal_code": "573800758",
            "telephone_number": "605-384-5419",
            "fax_number": "605-384-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY J FITZGERALD DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-384-5419",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7604080",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wagner Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wagner, SD

Sources for this page

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