Individual provider Active NPI

David John Portmann, D.C.

  • Chiropractor
  • Howards Grove, WI
National Provider Identifier
1073534616
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3724 Issued in WI
Practice address
516 S Wisconsin Dr
Howards Grove, WI 53083-1261
Phone
(920) 565-3922
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3724 WI Primary

Addresses

Primary practice location

516 S Wisconsin Dr
Howards Grove, WI 53083-1261

Mailing address

516 S Wisconsin Dr
Howards Grove, WI 53083-1261
Phone (920) 565-3922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050616000173 WI Practitioner - Chiropractic 5597709956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 E Waldo Blvd
Suite 1
Manitowoc, WI 54220-2912
Phone (920) 683-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3724WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Varish Chiropractic Clinics, LLC Chiropractor CurrentSince Dec 26, 2000 Accepting new patients
Manitowoc Chiropractic LLC Chiropractor CurrentSince Nov 8, 2023 Accepting new patients

Locations

1 E Waldo Blvd
Ste 1
Manitowoc, WI 54220
Phone (920) 683-3800

516 S Wisconsin Dr
Sheboygan, WI 53083
Phone (920) 565-3922

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073534616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 S WISCONSIN DR",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831261",
            "telephone_number": "920-565-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 S WISCONSIN DR",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831261",
            "telephone_number": "920-565-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTMANN",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howards Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.