Individual provider Active NPI

Kellen James Binder, D.C.

  • Chiropractor
  • Green Bay, WI
National Provider Identifier
1043556780
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4912-12 Issued in WI
Practice address
2638 Tulip Lane, Suite B
Green Bay, WI 54313
Phone
(920) 429-2844
Fax
(920) 429-2845
NPI assigned
Dec 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4912-12 WI Primary

Addresses

Primary practice location

2638 Tulip Lane, Suite B
Green Bay, WI 54313

Mailing address

2638 Tulip Lane, Suite B
Green Bay, WI 54313
Phone (920) 429-2844

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130316000053 WI Practitioner - Chiropractic 2860637063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Binder Family Chiropractic LLCGroup PAC ID 3173849338, 2 clinicians

Practice addresses (Care Compare)

Kenosha, WI 53142
Phone (262) 764-5390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4912-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Binder Family Chiropractic LLC Chiropractor CurrentSince Dec 27, 2014 Accepting new patients

Locations

10715 75th St
Kenosha, WI 53142
Phone (262) 764-5390

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1043556780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2638 TULIP LANE, SUITE B",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54313",
            "telephone_number": "920-429-2844",
            "fax_number": "920-429-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2638 TULIP LANE, SUITE B",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54313",
            "telephone_number": "920-429-2844",
            "fax_number": "920-429-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINDER",
        "first_name": "KELLEN",
        "middle_name": "JAMES",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-28",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4912-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.