Individual provider Active NPI

Curtis F Black, DC

  • Chiropractor
  • Eau Claire, WI
National Provider Identifier
1053497883
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2481 Issued in WI
Practice address
3004 Golf Rd
Suite 100
Eau Claire, WI 54701
Phone
(715) 834-4516
Fax
(715) 834-0552
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2481 WI Primary

Addresses

Primary practice location

3004 Golf Rd
Suite 100
Eau Claire, WI 54701

Mailing address

3004 Golf Rd
Suite 100
Eau Claire, WI 54701
Phone (715) 834-4516

Other identifiers 1

IdentifierTypeStateIssuer
38844100MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101020001568 WI Practitioner - Chiropractic 5294928339 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Chiropractic Center, S.C.Group PAC ID 2668402181, 5 clinicians

Practice addresses (Care Compare)

3420 Mall Dr
Suite 1
Eau Claire, WI 54701-8147
Phone (715) 832-3771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2481WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Chiropractic Center, S.C. Chiropractor CurrentSince Mar 28, 2022 Accepting new patients
McMahon Chiropractic and Physical Therapy Clinic LLC Chiropractor CurrentSince Feb 20, 2019 Accepting new patients

Locations

3004 Golf Rd
Ste 100
Eau Claire, WI 54701
Phone (715) 514-2827

3420 Mall Dr
Ste 1
Eau Claire, WI 54701
Phone (715) 832-3771

4330 Golf Ter
Ste 107
Eau Claire, WI 54701
Phone (715) 833-4960

Organizations & group practices 3

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1053497883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 GOLF RD",
            "address_2": "SUITE 100",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54701",
            "telephone_number": "715-834-4516",
            "fax_number": "715-834-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 GOLF RD",
            "address_2": "SUITE 100",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54701",
            "telephone_number": "715-834-4516",
            "fax_number": "715-834-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CURTIS",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38844100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.