Clint Ryan Dorn, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4025012 Issued in WI

Practice address

W6905 Parkview Dr
Suite B
Greenville, WI 54942-9099

Phone

(920) 757-5771

Fax

(920) 757-0373

NPI assigned

Dec 27, 2006

Last updated

Sep 16, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Chiropractic Health And Rehabilitation Center Professional name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chiropractic Health and Rehabilitation CenterGroup PAC ID 3971671967, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chiropractic Health & Rehabilitation Center

  • Chiropractor
  • Greenville, WI
  • NPI 1467667972
  Medicare reassignment Care Compare group NPD Authorized official
• Chiropractic Health of Neenah, LLC

  • Chiropractor
  • Neenah, WI
  • NPI 1881395051
  NPD (past) Authorized official
• Chiropractic Health of Oshkosh, LLC

  • Chiropractor
  • Oshkosh, WI
  • NPI 1306472618
  NPD (past) Authorized official

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1053476168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W6905 PARKVIEW DR",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "WI",
            "postal_code": "549429099",
            "telephone_number": "920-757-5771",
            "fax_number": "920-757-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W6905 PARKVIEW DR",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "WI",
            "postal_code": "549429099",
            "telephone_number": "920-757-5771",
            "fax_number": "920-757-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORN",
        "first_name": "CLINT",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4025012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38956200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIROPRACTIC HEALTH",
            "last_name": "REHABILITATION CENTER",
            "middle_name": "AND",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jamie Budzynski
• Chiropractic Health & Rehabilitation Center
• Janet Creapo, LMT
• Gabriel Dewar, DC
• Patrick Shannon Dewar, DC
• Julia Dudenas
• Julie Ann Duffy, LPC
• Harmony Ebbesen, MS, CCC-SLP
• Marina Eggen, DC
• Eternal Focus Christian Counseling LLC

• Chiropractor in Greenville, WI
• Providers in Greenville, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.