Individual provider Active NPI

Roxanne Wagner, D.C.

  • Chiropractor
  • Lakewood, CO
National Provider Identifier
1720446958
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR0007405 Issued in CO
Practice address
1890 S Wadsworth Blvd
Lakewood, CO 80232-6804
Phone
(720) 458-0487
Fax
(720) 458-0981
NPI assigned
Feb 2, 2016
Last updated
Jul 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR0007405 CO Primary

Addresses

Primary practice location

1890 S Wadsworth Blvd
Lakewood, CO 80232-6804

Mailing address

1890 S Wadsworth Blvd
Lakewood, CO 80232-6804
Phone (720) 458-0487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170404001011 CO Practitioner - Chiropractic 5991089419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHR0007405COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Chiropractic P.C. CurrentSince Nov 15, 2024 Accepting new patients

Locations

1890 S Wadsworth Blvd
Lakewood, CO 80232
Phone (720) 458-0487

2323 S Wadsworth Blvd
Lakewood, CO 80227
Phone (352) 538-7581

2323 S Wadsworth Blvd
Ste 201
Lakewood, CO 80227
Phone (720) 458-0487

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1720446958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 S WADSWORTH BLVD",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802326804",
            "telephone_number": "720-458-0487",
            "fax_number": "720-458-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 S WADSWORTH BLVD",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802326804",
            "telephone_number": "720-458-0487",
            "fax_number": "720-458-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ROXANNE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR0007405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.