James M Wagner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301008349 Issued in MI

Practice address

1162 Dexter St
Milan, MI 48160-1162

Phone

(734) 439-0100

Fax

(734) 439-7701

NPI assigned

Jan 6, 2006

Last updated

Dec 7, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Life Cycle Family Chiropractic, PC

  • Chiropractor
  • Milan, MI
  • NPI 1336280817
  NPD (past) Authorized official

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1851379044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162 DEXTER ST",
            "city": "MILAN",
            "state": "MI",
            "postal_code": "481601162",
            "telephone_number": "734-439-0100",
            "fax_number": "734-439-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162 DEXTER ST",
            "city": "MILAN",
            "state": "MI",
            "postal_code": "481601162",
            "telephone_number": "734-439-0100",
            "fax_number": "734-439-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JAMES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "12317",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "OH 13360",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "95-0-H1-1336-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Simna Soly Vadakal, MD
• Ethan Vaughn
• Hayley Wallace
• Wandering Roots Wellness PLLC
• Roger George Wheaton, R.PH.
• Christine Rose Williams, PA-C
• Nathan Steven Williams, DPT, PT

• Chiropractor in Milan, MI
• Providers in Milan, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.