Active NPI
Nathan S Wagner, D.C.
- Chiropractor
- Rogers, AR
National Provider Identifier
1922339167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 15713
- Practice address
- 4608 W Walnut St Ste a
Rogers, AR 72756-1404 - Phone
- (479) 899-6658
- Fax
- (479) 899-6685
- NPI assigned
- Jan 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 15713 | AR | Primary |
Addresses
Primary practice location
4608 W Walnut St Ste a
Rogers, AR 72756-1404
Mailing address
3105 NE 11TH St
Ste 3
Bentonville, AR 72712-9127
Phone (479) 899-6658
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521417600000",
"number": "1922339167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3105 NE 11TH ST",
"address_2": "STE 3",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727129127",
"telephone_number": "479-899-6658",
"fax_number": "479-899-6685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4608 W WALNUT ST STE A",
"city": "ROGERS",
"state": "AR",
"postal_code": "727561404",
"telephone_number": "479-899-6658",
"fax_number": "479-899-6685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "NATHAN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-28",
"last_updated": "2018-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "15713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rogers, AR
- Harrison Jake Waddell, DMD
- Jennifer Wade, O.T.
- Melissa Brooke Waganer, MOT, OTR/L
- Brian Waggoner, LAC, NCC
- Michael Waggoner, DO
- Allison Danielle Wahbi, LSW
- Wal-Mart Stores, Inc. (Vision Center 30-5260)
- Aimee Kathryne Waldrep, M.S, CCC-SLP
- Walgreen Co (Walgreens #05237)
- Walgreen Co (Walgreens #12500)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.