Colt Wyatt Wilde, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4797 Issued in NC

Practice address

3410 W Wendover Ave
Greensboro, NC 27407-1590

Phone

(336) 274-3500

Fax

(336) 292-1928

NPI assigned

Apr 12, 2018

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

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gys Chiro IncGroup PAC ID 9133146541, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gys Chiro Inc

  • Chiropractor
  • Greensboro, NC
  • NPI 1518949783
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1972000271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071590",
            "telephone_number": "336-274-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071590",
            "telephone_number": "336-274-3500",
            "fax_number": "336-292-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "COLT",
        "middle_name": "WYATT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mitchell Wilcox, RN
• Kassondra Marie Wilcox, LCSWA
• Lyndsay Wilcox, LCMHCA
• Richard Chadwick Wilcox, REGISTERED NURSE
• Wild Indigo Counseling Collective
• Alexandra Titus Wilder, APRN-BC
• Brandy Wilder, ITFS
• Carol A Wilder
• Michael Robert Wildman, LCAS, CCS
• Angela Wiley, LPC, LCAS, MAC

• Chiropractor in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.