Organization Active NPI

Fritz Chiropractic LLC

  • Chiropractor
  • Hartland, WI
National Provider Identifier
1083048318
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4761-12 Issued in WI
Legal business name
FRITZ CHIROPRACTIC LLC
Practice address
864 Rose Dr
Hartland, WI 53029-8317
Phone
(262) 367-4523
NPI assigned
Aug 22, 2013
Last updated
Aug 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Authorized official

Name
Joshua FritzNPI 1487932331
Title
Owner/Chiropractor
Phone
(815) 904-0850

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4761-12 WI Primary

Addresses

Primary practice location

864 Rose Dr
Hartland, WI 53029-8317

Mailing address

3522 S 14TH St
Milwaukee, WI 53221-1640
Phone (815) 904-0850

Other identifiers 1

IdentifierTypeStateIssuer
1487932331MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131025000761 WI Part B Supplier - Clinic/Group Practice 5799910873 Receives reassigned benefits from 1 practitioner
Practice locations: Milwaukee, WI

National Provider Directory

National Provider Directory

Locations

864 Rose Dr
Hartland, WI 53029
Phone (262) 367-4523

3116 S Kinnickinnic Ave
Milwaukee, WI 53207
Phone (414) 295-6045

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377129600000",
    "number": "1083048318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3522 S 14TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532211640",
            "telephone_number": "815-904-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 ROSE DR",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530298317",
            "telephone_number": "262-367-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRITZ CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A",
        "authorized_official_last_name": "FRITZ",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "815-904-0850"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4761-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487932331",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartland, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.