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Deactivated NPI 1215923156 Deactivated / Inactive NPI Male Practitioner

Dr. Timothy John Wagner , DC, BS

Chiropractor • Appleton, WI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Timothy Wagner has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 26, 2005
NPI Deactivation Date March 24, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Timothy Wagner, DC, BS was a registered Chiropractor practicing in Appleton, WI. Throughout an active medical career spanning 1 years, Dr. Wagner provided care at the practice location at 118 N DURKEE ST until profile deactivation on 2006-03-24.

Practice Location & Contact Primary Location

Practice Address

118 N Durkee St

Appleton, WI 549115427

Telephone 9208302225
Fax 9208302221

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Appleton, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 21.6 Yrs
State Avg: 22.4 Yrs
Regional Practice Density
89 Specialists

Practicing in Appleton, WI (2664 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License WI 4002-012

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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Updated Practice Location July 08, 2007

Registered at 118 N DURKEE ST, APPLETON, WI 549115427 (Tel: 9208302225)

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Updated Business Mailing Address July 08, 2007

Registered at 118 N DURKEE ST, APPLETON, WI 549115427 (Tel: 9208302225)

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Provider Name / Credentials Updated July 08, 2007

Recorded as TIMOTHY WAGNER, D.C., B.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Chiropractor (License #4002-012 in WI)

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NPI Profile Reactivated April 05, 2006

Record officially reactivated for active practice on April 05, 2006

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NPI Profile Deactivated March 24, 2006

Record deactivated on March 24, 2006

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Initial NPI Registration & Enumeration September 26, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1215923156
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 26, 2005
Last Update: July 13, 2026
Deactivation Date: March 24, 2006
Sole Proprietor: No

Mailing Address

118 N Durkee St

Appleton, WI 549115427

Phone: 9208302225

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.