Active NPI
John Andrew Wild, DC
- Chiropractor
- Seward, NE
National Provider Identifier
1780679704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1017
- Practice address
- 905 Main Street
Seward, NE 68434-2072 - Phone
- (402) 643-6565
- Fax
- (402) 643-4655
- NPI assigned
- Sep 15, 2005
- Last updated
- Nov 10, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1017 | NE | Primary |
Addresses
Primary practice location
905 Main Street
Seward, NE 68434-2072
Mailing address
905 Main Street
Seward, NE 68434-2072
Phone (402) 643-6565
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780679704 | Other | NE | NPI |
| 470825365 | Other | NE | TAX ID # |
| 350046510 | Other | NE | MEDICARE RR |
| 47082536500 | Medicaid | NE | |
| 272174 | Other | NE | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1017 | NE | MD | Orthopaedic Surgery Physician |
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.
-
- Chiropractor
- Seward, NE
- NPI 1831246990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447113600000",
"number": "1780679704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 MAIN STREET",
"city": "SEWARD",
"state": "NE",
"postal_code": "684342072",
"telephone_number": "402-643-6565",
"fax_number": "402-643-4655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 MAIN STREET",
"city": "SEWARD",
"state": "NE",
"postal_code": "684342072",
"telephone_number": "402-643-6565",
"fax_number": "402-643-4655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILD",
"first_name": "JOHN",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-15",
"last_updated": "2015-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NE",
"license": "1017",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1780679704",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "470825365",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "350046510",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47082536500",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "272174",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seward, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.