Individual provider Active NPI

Shannon Michelle Stadler, D.C.

  • Chiropractor
  • Delafield, WI
National Provider Identifier
1023323789
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4613-12 Issued in WI
Practice address
1452 Genesee St
Delafield, WI 53018-1432
Phone
(262) 646-5800
Fax
(262) 646-5803
NPI assigned
Aug 18, 2010
Last updated
Aug 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4613-12 WI Primary

Addresses

Primary practice location

1452 Genesee St
Delafield, WI 53018-1432

Mailing address

1452 Genesee St
Delafield, WI 53018-1432
Phone (262) 646-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000873 WI Practitioner - Chiropractic 0345437331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

711 Main St
Delafield, WI 53018-1507
Phone (262) 232-7910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stadler Chiropractic, LLC Chiropractor CurrentSince Jan 3, 2018 Accepting new patients
Lake Country Health Center, SC Chiropractor PastSince Apr 1, 2004 Accepting new patients

Locations

711 Main St
Delafield, WI 53018
Phone (262) 232-7910

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1023323789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 GENESEE ST",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181432",
            "telephone_number": "262-646-5800",
            "fax_number": "262-646-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1452 GENESEE ST",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181432",
            "telephone_number": "262-646-5800",
            "fax_number": "262-646-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADLER",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4613-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delafield, WI

Sources for this page

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