Individual provider Active NPI

Kenneth J Krieser, D.C.

  • Chiropractor
  • Nashotah, WI
National Provider Identifier
1013973155
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4167-012 Issued in WI
Practice address
W329N4362 Lakeland Dr
Nashotah, WI 53058-9708
Phone
(262) 563-1000
Fax
(262) 563-1200
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4167-012 WI Primary

Addresses

Primary practice location

W329N4362 Lakeland Dr
Nashotah, WI 53058-9708

Mailing address

W329N4362 Lakeland Dr
Nashotah, WI 53058-9708
Phone (262) 563-1000

Other identifiers 1

IdentifierTypeStateIssuer
38967400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060307000138 WI Practitioner - Chiropractic 6901812767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

W329N4362 Lakeland Dr
Nashotah, WI 53058-9708
Phone (262) 563-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4167-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Krieser Family Chiropractic, LLC Chiropractor CurrentSince Feb 1, 2006 Accepting new patients

Networks

  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1013973155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W329N4362 LAKELAND DR",
            "city": "NASHOTAH",
            "state": "WI",
            "postal_code": "530589708",
            "telephone_number": "262-563-1000",
            "fax_number": "262-563-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W329N4362 LAKELAND DR",
            "city": "NASHOTAH",
            "state": "WI",
            "postal_code": "530589708",
            "telephone_number": "262-563-1000",
            "fax_number": "262-563-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIESER",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4167-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38967400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashotah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.

Verify at the official NPI Registry.