Gregory Robert Haas, D.C.
Individual provider Active NPI Chiropractor · Stanley, WI
NPI 1043554561 · NPPES record last updated Nov 27, 2017
Key facts
- NPI
- 1043554561
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4906-12 (WI)
- Practice address
- 123 N Broadway St
Stanley, WI 54768-1005 - Phone
- (715) 644-5677
- NPI assigned
- Nov 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stanley Family Chiropractic LLC
Practice addresses (Care Compare)
123 N Broadway St
Stanley, WI 54768-1005
Phone (715) 644-5677
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130311000057 | WI | Practitioner - Chiropractic | 8820243280 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4906-12 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4906-12 | WI | Yes |
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
Other providers in Stanley, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.