Individual provider Active NPI

Emma Jeanette Hervat, DC

  • Chiropractor
  • Lake Geneva, WI
National Provider Identifier
1083233068
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5534-12 Issued in WI
Practice address
820 Geneva Pkwy N Unit 105
Lake Geneva, WI 53147-4562
Phone
(262) 248-6700
Fax
(262) 248-6764
NPI assigned
Apr 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5534-12 WI Primary

Addresses

Primary practice location

820 Geneva Pkwy N Unit 105
Lake Geneva, WI 53147-4562

Mailing address

820 Geneva Pkwy N
Ste 105
Lake Geneva, WI 53147-4562
Phone (262) 248-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200612001341 WI Practitioner - Chiropractic 5991127342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Family Chiropractic and Wellness IncGroup PAC ID 6507850658, 3 clinicians

Practice addresses (Care Compare)

820 Geneva Pkwy N
Suite 105
Lake Geneva, WI 53147-4562
Phone (262) 248-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Family Chiropractic and Wellness Inc Chiropractor CurrentSince Apr 10, 2020 Accepting new patients

Locations

820 Geneva Pkwy N
Ste 105
Lake Geneva, WI 53147
Phone (262) 248-6700

Organizations & group practices 1

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1083233068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 GENEVA PKWY N",
            "address_2": "STE 105",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474562",
            "telephone_number": "262-248-6700",
            "fax_number": "262-486-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 GENEVA PKWY N UNIT 105",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474562",
            "telephone_number": "262-248-6700",
            "fax_number": "262-248-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERVAT",
        "first_name": "EMMA",
        "middle_name": "JEANETTE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5534-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.