NPIMap

Organization Active NPI

Wagner Chiropractic P.C.

  • Chiropractor
  • Sioux City, IA
National Provider Identifier
1750521209
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06696 Issued in IA
Legal business name
WAGNER CHIROPRACTIC P.C.
Practice address
1723 Grandview Blvd
Sioux City, IA 51105-1116
Phone
(712) 258-1021
Fax
(712) 233-6049
NPI assigned
Feb 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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

Authorized official

Name
Dr. Jamison Matthew Wagner, D.C.
Title
President
Phone
(712) 258-1021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 06696 IA Primary

Addresses

Primary practice location

1723 Grandview Blvd
Sioux City, IA 51105-1116

Mailing address

1723 Grandview Blvd
Sioux City, IA 51105-1116
Phone (712) 258-1021

Other names 1

  • Wagner Chiropractic Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235433600000",
    "number": "1750521209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 GRANDVIEW BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051116",
            "telephone_number": "712-258-1021",
            "fax_number": "712-233-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 GRANDVIEW BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051116",
            "telephone_number": "712-258-1021",
            "fax_number": "712-233-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-02-24",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "JAMISON",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-258-1021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wagner Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; 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.