Seth Andrew Wagenblast, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

9995 Issued in TX

Practice address

102 E Main St
Suite a
Round Rock, TX 78664-5200

Phone

(512) 284-9278

Fax

(512) 284-9283

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wagenblast Chiropractic, PLLC

  dba Active Sports Therapy and Rehabilitation

  • Sports Physician Chiropractor
  • Round Rock, TX
  • NPI 1235418666
  NPD (past) Authorized official

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1821199126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3924 WALSH RANCH BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786812441",
            "telephone_number": "512-284-9278",
            "fax_number": "512-284-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E MAIN ST",
            "address_2": "SUITE A",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786645200",
            "telephone_number": "512-284-9278",
            "fax_number": "512-284-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGENBLAST",
        "first_name": "SETH",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9995",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "9995",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "9995",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "TX",
            "license": "9995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Vu
• W. Ryan Butler OD PLLC
• Aubrie Wade
• Jeanine Wade, PHD
• Wagenblast Chiropractic, PLLC (Active Sports Therapy and Rehabilitation)
• Mary Katherine Wagner, CPHT
• Nancy W Waiganjo, MD
• Amrita Anil Waingankar, M.B.B.S
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0475)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-5480)

• Chiropractor in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.