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VANDER WIELEN HEALTH & WELLNESS DIAGNOSTIC CENTER, LLC
NPI 1063741015
Chiropractor - Internist in Menasha, WI

Active since December 21, 2009CLIA 52D2001466 · Waiver
1486 KENWOOD DR, MENASHA, WI 54952(920) 722-2100(920) 722-2100 Get Directions Write a Review

NPPES record last updated: June 16, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Vander Wielen Health & Wellness Diagnostic Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VANDER WIELEN HEALTH & WELLNESS DIAGNOSTIC CENTER, LLC (NPI 1063741015) is a healthcare organization registered as an internist in Menasha, Wisconsin and active in the NPI registry since December 2009. The organization holds a CLIA Waiver certificate valid through December 20, 2027 and lists Scott Martin Vander Wielen, Registered Agent, as its authorized official.

NPPES Registry Identity

NPI1063741015
Entity TypeOrganization
Primary Taxonomy111NI0900X
Legal Business NameVANDER WIELEN HEALTH & WELLNESS DIAGNOSTIC CENTER, LLC
Location Address1486 KENWOOD DRMenasha, WI 54952-1133
Mailing Address1486 Kenwood DrMenasha, WI 54952-1133 · (920) 722-2100 · Fax (920) 722-2101
Phone(920) 722-2100
Fax(920) 722-2100
Organization SubpartNo
Authorized OfficialScott Martin Vander WielenRegistered Agent · (920) 722-2100
Enumeration DateDecember 21, 2009
Last NPPES UpdateJune 16, 2022
NPPES CertifiedJune 16, 2022
✔ NPI 1063741015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractor · InternistChiropractic Providers
Taxonomy Code111NI0900X
Definition
The chiropractic internist may serve as a primary care physician or may see patients referred from other providers for evaluation and co-management. Evaluation is focused on the early detection of functional, nutritional, and pathological disorders. A chiropractic internist utilizes the diagnostic instruments necessary for proper examination. In cases where laboratory examination is necessary, a chiropractic internist utilizes a recognized reference laboratory facility. A chiropractic internist may manage his or her own cases or may refer to another specialist when prudent to do so. The chiropractic internist utilizes documented natural therapies, therapeutic lifestyle changes, patient education and other resources to promote patient health and avoidance of disease.
1486 KENWOOD DR, Menasha, WI 54952
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2001466

Vander Wielen Health & Wellness Diagnostic Center LLC · Menasha, WI
Active · expires Dec 20, 2027
CLIA Number52D2001466
Laboratory TypePractitioner Other
Certificate Effective DateDecember 21, 2025
Certificate Expiration DateDecember 20, 2027
Laboratory DirectorDr. Scott M. Vander Wielen Dc
Laboratory Phone(920) 739-8949
Laboratory LocationVander Wielen Health & Wellness Diagnostic Center LLC1486 Kenwood Drive 1st Floor, Menasha, WI 54952
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. SCOTT MARTIN VANDER WIELEN D.C.
Chiropractor
1486 KENWOOD DR
MENASHA, WI 54952
Calumet County (920) 722-2100
RISING HOPE FAMILY COUNSELING CENTER, LLC
Social Worker (Clinical)
1486 KENWOOD DR
MENASHA, WI 54952
Calumet County (920) 739-2100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vander Wielen Health & Wellness Diagnostic Center, LLC's NPI number?

The NPI number for Vander Wielen Health & Wellness Diagnostic Center, LLC is 1063741015. It was assigned to this organization in the NPPES registry on December 21, 2009.

Where is Vander Wielen Health & Wellness Diagnostic Center, LLC located?

Vander Wielen Health & Wellness Diagnostic Center, LLC is located at 1486 Kenwood Dr, Menasha, WI 54952. The listed phone number is (920) 722-2100.

What is Vander Wielen Health & Wellness Diagnostic Center, LLC's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Internist, with taxonomy code 111NI0900X.

Does Vander Wielen Health & Wellness Diagnostic Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2001466) is associated with this NPI, valid through December 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Vander Wielen Health & Wellness Diagnostic Center, LLC was last updated on June 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.