Chiropractic Care Center-Waukesha,LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3572 Issued in WI

Legal business name

CHIROPRACTIC CARE CENTER-WAUKESHA,LLC

Practice address

6400 Industrial Loop
Greendale, WI 53129-2452

Phone

(414) 423-4100

Fax

(414) 423-4134

NPI assigned

Nov 16, 2007

Last updated

Aug 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Laura A Dull, DCNPI 1831206879

Title

Chiropractor

Phone

(262) 542-9814

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 2

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.

• Laura Ann Dull, DC

  • Chiropractor
  • Waukesha, WI
  • NPI 1831206879
  Medicare reassignment Care Compare group NPD Authorized official
• Ethan A. Dull, D.C.

  • Rehabilitation Chiropractor
  • Pewaukee, WI
  • NPI 1699831909
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408060800000",
    "number": "1063693166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 N GRANDVIEW BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882894",
            "telephone_number": "262-542-9814",
            "fax_number": "262-542-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC CARE CENTER-WAUKESHA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2014-08-15",
        "status": "A",
        "authorized_official_last_name": "DULL",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "262-542-9814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; 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.