NPIMap

Organization Active NPI

Elite Sport & Spine, LLC

  • Chiropractor
  • Waukesha, WI
National Provider Identifier
1053740803
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4968-12 Issued in WI
Legal business name
ELITE SPORT & SPINE, LLC
Practice address
20900 Swenson Dr Ste 575
Waukesha, WI 53186-4040
Phone
(262) 373-9168
Fax
(262) 226-8383
NPI assigned
Nov 2, 2013
Last updated
Jun 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Dr. Zach Shiels, DCNPI 1568891497
Title
Owner/Doctor of Chiropractic
Phone
(262) 373-9168

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4968-12 WI Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

20900 Swenson Dr Ste 575
Waukesha, WI 53186-4040

Mailing address

20900 Swenson Dr Ste 575
Waukesha, WI 53186-4040
Phone (262) 373-9168

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140109000133 WI Part B Supplier - Clinic/Group Practice 4880822345 Receives reassigned benefits from 3 practitioners
Practice locations: Waukesha, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1053740803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20900 SWENSON DR STE 575",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864040",
            "telephone_number": "262-373-9168",
            "fax_number": "262-226-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20900 SWENSON DR STE 575",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864040",
            "telephone_number": "262-373-9168",
            "fax_number": "262-226-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SPORT & SPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "SHIELS",
        "authorized_official_first_name": "ZACH",
        "authorized_official_title_or_position": "OWNER/DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "262-373-9168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4968-12",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.