Groth Chiropractic Clinc Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

410912 Issued in WI

Legal business name

GROTH CHIROPRACTIC CLINC INC

Practice address

1540 Heritage Blvd
Suite 203
West Salem, WI 54669-1417

Phone

(608) 786-3670

Fax

(608) 786-3672

NPI assigned

Dec 11, 2015

Organization subpart

No

Name

Kevin P Groth, DCNPI 1255350542

Title

Owner

Phone

(608) 786-3670

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin P Groth, DC

  • Chiropractor
  • West Salem, WI
  • NPI 1255350542

  Chiropractor, WI

  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in WI

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 11, 2015.

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1043685316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 HERITAGE BLVD",
            "address_2": "SUITE 203",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546691417",
            "telephone_number": "608-786-3670",
            "fax_number": "608-786-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 HERITAGE BLVD",
            "address_2": "SUITE 203",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546691417",
            "telephone_number": "608-786-3670",
            "fax_number": "608-786-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROTH CHIROPRACTIC CLINC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "GROTH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-786-3670",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "410912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Gelbmann, LMT
• Kathryn A Gerstenberger, OTR
• Erin Gleason, MT-BC, WMTR
• Ashley Gravelle, DC
• Dennis Read Greer, ATC
• Kevin P Groth, DC
• Andrea Jayne Halvorson, MA, MT-BC, WMTR
• Lauren Renee Harding, PT
• Rebecca Helmeid, MT-BC
• Josie Marie Hemesath, MT-BC

• All providers in West Salem, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.