Individual provider Active NPI

Wayne D Middeker, DC

  • Chiropractor
  • Westminster, CO
National Provider Identifier
1790819795
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3560 Issued in CO
Practice address
11859 Pecos St Ste 310
Westminster, CO 80234-2742
Phone
(303) 428-1914
Fax
(303) 429-2783
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3560 CO Primary

Addresses

Primary practice location

11859 Pecos St Ste 310
Westminster, CO 80234-2742

Mailing address

11859 Pecos St Ste 310
Westminster, CO 80234-2742
Phone (303) 428-1914

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091209000110 CO Practitioner - Chiropractic 2567501273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11859 Pecos St
Suite 310
Westminster, CO 80234-2742
Phone (303) 428-1914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3560COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Works Nnorth PC Chiropractor CurrentSince Nov 1, 2009 Accepting new patients

Locations

20 W 84th Ave
Thornton, CO 80260
Phone (303) 428-1914

11859 Pecos St
Ste 310
Westminster, CO 80234
Phone (303) 428-1914

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1790819795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11859 PECOS ST STE 310",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342742",
            "telephone_number": "303-428-1914",
            "fax_number": "303-429-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11859 PECOS ST STE 310",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342742",
            "telephone_number": "303-428-1914",
            "fax_number": "303-429-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDEKER",
        "first_name": "WAYNE",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "3560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.