Active NPI
Brady Spielbauer, DC
- Chiropractor
- De Pere, WI
National Provider Identifier
1033795604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5616-12
- Practice address
- 1702 Scheuring Rd Ste C
De Pere, WI 54115-9567 - Phone
- (920) 227-1331
- Fax
- (920) 632-7870
- NPI assigned
- Mar 23, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Health Chiropractor | 111NX0100X | 5616-12 | WI | |
| Chiropractor | 111N00000X | 5616-12 | WI | Primary |
Addresses
Primary practice location
1702 Scheuring Rd Ste C
De Pere, WI 54115-9567
Mailing address
1702 Scheuring Rd Ste C
De Pere, WI 54115-9567
Phone (920) 227-1331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5616-12 | WI | MD | Occupational Health Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1033795604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 SCHEURING RD STE C",
"city": "DE PERE",
"state": "WI",
"postal_code": "541159567",
"telephone_number": "920-227-1331",
"fax_number": "920-632-7870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 SCHEURING RD STE C",
"city": "DE PERE",
"state": "WI",
"postal_code": "541159567",
"telephone_number": "920-227-1331",
"fax_number": "920-632-7870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPIELBAUER",
"first_name": "BRADY",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-23",
"last_updated": "2021-03-23",
"certification_date": "2021-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "111NX0100X",
"taxonomy_group": "",
"desc": "Chiropractor, Occupational Health",
"state": "WI",
"license": "5616-12",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "5616-12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Pere, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.