Individual provider Active NPI

Daniel E Czelatdko, DC

  • Nutrition Chiropractor
  • Eau Claire, WI
National Provider Identifier
1043329741
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
2840 Issued in WI
Practice address
3814 Oakwood Hills Pkwy
Eau Claire, WI 54701-7757
Phone
(715) 833-8777
Fax
(715) 833-8774
NPI assigned
Aug 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 2840 WI Primary

Addresses

Primary practice location

3814 Oakwood Hills Pkwy
Eau Claire, WI 54701-7757

Mailing address

E8475 W Mallard Rd
Strum, WI 54770-5401
Phone (715) 833-8777

Other identifiers 1

IdentifierTypeStateIssuer
38863400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111109000766 WI Practitioner - Chiropractic 3476726340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

515 S Barstow St
Suite 115
Eau Claire, WI 54701-2618
Phone (715) 497-7258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2840WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Farm Doc Chiropractic LLC CurrentSince Dec 14, 2024 Accepting new patients
Wisconsin Center for Integrative Health, SC PastSince Apr 1, 1997 Accepting new patients
Chippewa Falls Chiropractic, S.C. PastSince Dec 1, 2015 Accepting new patients
Stender Orthopedic and Chiropractic Clinic Inc PastSince Mar 31, 2014 Accepting new patients

Locations

515 S Barstow St
Ste 115
Eau Claire, WI 54701
Phone (715) 497-7258

Organizations & group practices 4

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043329741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E8475 W MALLARD RD",
            "city": "STRUM",
            "state": "WI",
            "postal_code": "547705401",
            "telephone_number": "715-833-8777",
            "fax_number": "715-833-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 OAKWOOD HILLS PKWY",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017757",
            "telephone_number": "715-833-8777",
            "fax_number": "715-833-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZELATDKO",
        "first_name": "DANIEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "WI",
            "license": "2840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38863400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, 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.

Verify at the official NPI Registry.