Individual provider Active NPI

Hans Orrin Wiederrich, D.C.

  • Chiropractor
  • Poway, CA
National Provider Identifier
1861552499
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC23611 Issued in CA
Practice address
14103 Poway Rd
Poway, CA 92064-4926
Phone
(858) 748-4343
Fax
(858) 748-4881
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC23611 CA Primary

Addresses

Primary practice location

14103 Poway Rd
Poway, CA 92064-4926

Mailing address

14103 Poway Rd
Poway, CA 92064-4926
Phone (858) 748-4343

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050322000716 CA Practitioner - Chiropractic 6305891599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14103 Poway Rd
Poway, CA 92064-4926
Phone (858) 748-4343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23611CAMDPsychologist
DC23611CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Scott R Gilford DC, a Chiropractic Corporation Chiropractor PastSince Feb 14, 2002 Accepting new patients

Organizations & group practices 2

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1861552499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14103 POWAY RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644926",
            "telephone_number": "858-748-4343",
            "fax_number": "858-748-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14103 POWAY RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644926",
            "telephone_number": "858-748-4343",
            "fax_number": "858-748-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDERRICH",
        "first_name": "HANS",
        "middle_name": "ORRIN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.