Clinton Chiropractic Clinic SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3029012 Issued in WI

Legal business name

CLINTON CHIROPRACTIC CLINIC SC

Practice address

400 Ogden Ave
Clinton, WI 53525-9005

Phone

(608) 676-2210

Fax

(608) 676-5947

NPI assigned

Jul 7, 2005

Last updated

Nov 18, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian D Dittmann, DCNPI 1144381971

Title

Owner Operator

Phone

(608) 676-2210

Specialties & licenses 1

Addresses

Other names 1

• Clinton Chiropractic Clinic SC Other name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian D Dittmann, DC

  • Chiropractor
  • Clinton, WI
  • NPI 1144381971
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1003813817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 OGDEN AVE",
            "city": "CLINTON",
            "state": "WI",
            "postal_code": "535259005",
            "telephone_number": "608-676-2210",
            "fax_number": "608-676-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OGDEN AVE",
            "city": "CLINTON",
            "state": "WI",
            "postal_code": "535259005",
            "telephone_number": "608-676-2210",
            "fax_number": "608-676-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON CHIROPRACTIC CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "DITTMANN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "608-676-2210",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3029012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinton Chiropractic Clinic SC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alden-Meadow Park Health Care Center, Inc.
• Aurora Pharmacy Inc (Aurora Pharmacy)
• Beloit Cliniic, S.C.
• Beloit Health System, Inc (Clinton Clinic - BHS)
• Christine K Bestor, 82229-30
• Clinton Community School District
• Clinton Fire Protection District
• Clinton Pharmacy LLC (Clinton Pharmacy)
• Lara Damico
• Nicholas Damman

• Chiropractor in Clinton, WI
• Providers in Clinton, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.