Vicky Wildermuth

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1483 Issued in SC

Practice address

829 Front St Ste H
Georgetown, SC 29440-3564

Phone

(843) 323-5560

Fax

(843) 388-5204

NPI assigned

Oct 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Vicky Wildermuth Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1841442076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 BEN SAWYER BLVD STE 7",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294644593",
            "telephone_number": "843-323-5560",
            "fax_number": "843-388-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 FRONT ST STE H",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403564",
            "telephone_number": "843-323-5560",
            "fax_number": "843-388-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDERMUTH",
        "first_name": "VICKY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKY",
            "last_name": "WILDERMUTH",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Roxanne Braxton Weaver, DDS
• Aubrey Westwood
• Robert T Whitehead III, MD
• Melanie Whitman, DO
• Dayna Chinners Wilder, APRN
• Michelline Cooper Williams, RN, MSN
• Barbara Lee Williamson, N.P.
• Deontay Adrain Winchester, LMSW
• Jason Wingard, OTR/L
• Fredrick Winns

• Chiropractor in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.