Active NPI
Gregory Michael Blau, D.C.
- Chiropractor
- Brookfield, WI
National Provider Identifier
1003931437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1560
- Practice address
- 14625 W Lisbon Rd
Brookfield, WI 53005-1626 - Phone
- (262) 783-5010
- Fax
- (262) 783-9992
- NPI assigned
- Mar 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1560 | WI | Primary |
Addresses
Primary practice location
14625 W Lisbon Rd
Brookfield, WI 53005-1626
Mailing address
W222N2728 Stonewood LN
Waukesha, WI 53186-1035
Phone (262) 547-2528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101201000232 | WI | Practitioner - Chiropractic | 2567658693 | Practice locations: Brookfield, WI |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1980
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
14625 W Lisbon Rd
Brookfield, WI 53005-1626
Phone (262) 783-5010
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1560 | WI | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003931437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W222N2728 STONEWOOD LN",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531861035",
"telephone_number": "262-547-2528",
"fax_number": "262-783-9992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14625 W LISBON RD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530051626",
"telephone_number": "262-783-5010",
"fax_number": "262-783-9992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAU",
"first_name": "GREGORY",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "1560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.