Active NPI
Family Chiropractic Clinic Inc
- Chiropractor
- Madison, WI
National Provider Identifier
1083735583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1579
- Legal business name
- FAMILY CHIROPRACTIC CLINIC INC
- Practice address
- 2205 N Sherman Ave
Madison, WI 53704-3310 - Phone
- (608) 244-0044
- NPI assigned
- Apr 2, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Brent McNabb, DC
- Title
- Chiropractor
- Phone
- (608) 244-0044
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1579 | WI | Primary |
Addresses
Primary practice location
2205 N Sherman Ave
Madison, WI 53704-3310
Mailing address
2205 N Sherman Ave
Madison, WI 53704-3310
Phone (608) 244-0044
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346212099 | Other | WI | DANIEL SODERHOLM NPI |
| 38777500 | Medicaid | WI | |
| 1083686737 | Other | WI | ROSS ROYSTER NPI |
| 1356313001 | Other | WI | BRENT MCNABB NPI |
| 1692 | Other | WI | DANIEL SODERHOLM LICENSE |
| 38767300 | Medicaid | WI | |
| 1579 | Other | WI | BRENT MCNABB LICENSE |
| 38767400 | Medicaid | WI | |
| 1619 | Other | WI | ROSS ROYSTER LICENSE |
Other names 1
- MADISON CHIROPRACTIC NORTH
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050913000477 | WI | Part B Supplier - Clinic/Group Practice | 4688607476 |
Receives reassigned benefits from 4 practitioners Practice locations: Madison, WI |
National Provider Directory
National Provider DirectoryLocations
2205 N Sherman Ave
Madison, WI 53704
Phone (608) 224-0044
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Madison, WI
- NPI 1235451493
-
- Chiropractor
- Madison, WI
- NPI 1609048594
-
- Chiropractor
- Sun Prairie, WI
- NPI 1477901551
-
- Chiropractor
- Madison, WI
- NPI 1104512961
-
- Chiropractor
- Madison, WI
- NPI 1356313001
-
- Chiropractor
- Columbus, WI
- NPI 1235181975
-
- Chiropractor
- Madison, WI
- NPI 1346212099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1354060800000",
"number": "1083735583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2205 N SHERMAN AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537043310",
"telephone_number": "608-244-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2205 N SHERMAN AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537043310",
"telephone_number": "608-244-0044"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY CHIROPRACTIC CLINIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-02",
"last_updated": "2012-11-28",
"status": "A",
"authorized_official_last_name": "MCNABB",
"authorized_official_first_name": "BRENT",
"authorized_official_title_or_position": "CHIROPRACTOR",
"authorized_official_telephone_number": "608-244-0044",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "WI",
"license": "1579",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DANIEL SODERHOLM NPI",
"identifier": "1346212099",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38777500",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ROSS ROYSTER NPI",
"identifier": "1083686737",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BRENT MCNABB NPI",
"identifier": "1356313001",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DANIEL SODERHOLM LICENSE",
"identifier": "1692",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38767300",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BRENT MCNABB LICENSE",
"identifier": "1579",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38767400",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ROSS ROYSTER LICENSE",
"identifier": "1619",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MADISON CHIROPRACTIC NORTH",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.