Vandecastle Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3212 Issued in WI

Legal business name

VANDECASTLE CHIROPRACTIC, LLC

Practice address

16 N Madison St
Waupun, WI 53963-1129

Phone

(920) 324-8776

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Vandecastle, D.C.NPI 1679613061

Title

Owner

Phone

(920) 324-8776

Specialties & licenses 1

Addresses

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.

• Michael John Vandecastle, D.C.

  • Chiropractor
  • Waupun, WI
  • NPI 1679613061
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003938929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 283",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539630283",
            "telephone_number": "920-324-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N MADISON ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631129",
            "telephone_number": "920-324-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDECASTLE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANDECASTLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-324-8776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna L Thomas, OTR, CKTP
• Peter W Timmermans, MD
• Amy J. Tisdale, LPN
• Torria Van Buren, PSY.D
• Van'S Corner Drug
• Michael John Vandecastle, D.C.
• James Alfred Vanderwerff, R.PH
• VB Anesthesia
• Nicholas James Victor
• Vita Park Eye Associates, SC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.