Organization Active NPI

Haanen Zilisch Smith Chiropractic Clinic LLC

  • Chiropractor
  • Kaukauna, WI
National Provider Identifier
1003032178
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HAANEN ZILISCH SMITH CHIROPRACTIC CLINIC LLC
Practice address
1801 Crooks Ave
Kaukauna, WI 54130-3245
Phone
(920) 766-9411
Fax
(920) 766-9412
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Authorized official

Name
Dr. Todd Lawrence Smith, D.C.NPI 1639230741
Title
Doctor
Phone
(920) 766-9411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X WI Primary

Addresses

Primary practice location

1801 Crooks Ave
Kaukauna, WI 54130-3245

Mailing address

1801 Crooks Ave
Kaukauna, WI 54130-3245
Phone (920) 766-9411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100603000516 WI Part B Supplier - Clinic/Group Practice 2668501495 Receives reassigned benefits from 2 practitioners
Practice locations: Kaukauna, WI

National Provider Directory

National Provider Directory

Locations

1801 Crooks Ave
Kaukauna, WI 54130
Phone (920) 766-9411

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1003032178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 CROOKS AVE",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541303245",
            "telephone_number": "920-766-9411",
            "fax_number": "920-766-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 CROOKS AVE",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541303245",
            "telephone_number": "920-766-9411",
            "fax_number": "920-766-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAANEN ZILISCH SMITH CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "920-766-9411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaukauna, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.