Individual provider Active NPI

Gregory Robert Haas, D.C.

  • Chiropractor
  • Stanley, WI
National Provider Identifier
1043554561
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4906-12 Issued in WI
Practice address
123 N Broadway St
Stanley, WI 54768-1005
Phone
(715) 644-5677
NPI assigned
Nov 21, 2012
Last updated
Nov 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4906-12 WI Primary

Addresses

Primary practice location

123 N Broadway St
Stanley, WI 54768-1005

Mailing address

123 N Broadway St
Stanley, WI 54768-1005
Phone (715) 644-5677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130311000057 WI Practitioner - Chiropractic 8820243280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanley Family Chiropractic LLCGroup PAC ID 6800035551, 3 clinicians

Practice addresses (Care Compare)

123 N Broadway St
Stanley, WI 54768-1005
Phone (715) 644-5677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4906-12WIMDChiropractor

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, 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": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1043554561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N BROADWAY ST",
            "city": "STANLEY",
            "state": "WI",
            "postal_code": "547681005",
            "telephone_number": "715-644-5677",
            "fax_number": "715-644-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N BROADWAY ST",
            "city": "STANLEY",
            "state": "WI",
            "postal_code": "547681005",
            "telephone_number": "715-644-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "GREGORY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-21",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4906-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanley, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.