Individual provider Active NPI

Tara Anne Osterholz, D.C

  • Chiropractor
  • Verona, WI
National Provider Identifier
1053646331
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4535-012 Issued in WI
Practice address
413 W Verona Ave
Verona, WI 53593-1318
Phone
(608) 732-1037
NPI assigned
Oct 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 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 4535-012 WI Primary

Addresses

Primary practice location

413 W Verona Ave
Verona, WI 53593-1318

Mailing address

PO Box 930226
Verona, WI 53593-0226
Phone (608) 732-1037

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100222000869 WI Practitioner - Chiropractic 7214071729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Verona Chiropractic LLCGroup PAC ID 6800031253, 3 clinicians

Practice addresses (Care Compare)

413 W Verona Ave
Verona, WI 53593-1318
Phone (608) 497-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4535-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Verona Chiropractic, LLC Chiropractor CurrentSince Feb 1, 2013 Accepting new patients
Belleville Chiropractic and Wellness Center, S.C. Chiropractor PastSince May 24, 2007 Accepting new patients

Locations

413 W Verona Ave
Verona, WI 53593
Phone (608) 497-3000

Organizations & group practices 2

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": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1053646331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 930226",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535930226",
            "telephone_number": "608-732-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W VERONA AVE",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931318",
            "telephone_number": "608-732-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERHOLZ",
        "first_name": "TARA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4535-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.