Individual provider Active NPI

Scott A Vanwagner, DC

  • Chiropractor
  • Glen Allen, VA
National Provider Identifier
1972615557
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104555873 Issued in VA
Practice address
10857 W Broad St
Glen Allen, VA 23060-3312
Phone
(804) 270-3000
Fax
(804) 270-3004
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104555873 VA Primary

Addresses

Primary practice location

10857 W Broad St
Glen Allen, VA 23060-3312

Mailing address

10857 W Broad St
Glen Allen, VA 23060-3312
Phone (804) 270-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111216000116 VA Practitioner - Chiropractic 0042485286 Practice locations: Glen Allen, VA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10857 W Broad St
Glen Allen, VA 23060-3312
Phone (804) 270-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104555873VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vanwagner Inc Chiropractor CurrentSince Sep 1, 2019 Accepting new patients
Health First Chiropractic, Inc Chiropractor PastSince Nov 8, 2011 Accepting new patients

Locations

10857 W Broad St
Glen Allen, VA 23060
Phone (804) 270-3000

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1972615557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10857 W BROAD ST",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603312",
            "telephone_number": "804-270-3000",
            "fax_number": "804-270-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10857 W BROAD ST",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603312",
            "telephone_number": "804-270-3000",
            "fax_number": "804-270-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWAGNER",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.