Individual provider Active NPI

Roby Christian Dorn, D.C.

  • Chiropractor
  • Oconomowoc, WI
National Provider Identifier
1083756167
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4053-012 Issued in WI
Practice address
W359N5002 Brown St Ste 220a
Oconomowoc, WI 53066-3366
Phone
(262) 203-9036
Fax
(262) 203-9774
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4053-012 WI Primary

Addresses

Primary practice location

W359N5002 Brown St Ste 220a
Oconomowoc, WI 53066-3366

Mailing address

W359N5002 Brown St Ste 220a
Oconomowoc, WI 53066-3366
Phone (262) 203-9036

Other identifiers 1

IdentifierTypeStateIssuer
38958700MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000283 WI Practitioner - Chiropractic 2062478050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

W359N5002 Brown St
Suite 220a
Oconomowoc, WI 53066-3366
Phone (262) 203-9036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4053-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dorn Family Chiropractic LLC Chiropractor CurrentSince Aug 27, 2004 Accepting new patients

Locations

1280 Brown St
Ste K2
Oconomowoc, WI 53066
Phone (262) 203-9036

W359N5002 Brown St
Ste 220A
Oconomowoc, WI 53066
Phone (262) 203-9036

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1083756167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W359N5002 BROWN ST STE 220A",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663366",
            "telephone_number": "262-203-9036",
            "fax_number": "262-203-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W359N5002 BROWN ST STE 220A",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663366",
            "telephone_number": "262-203-9036",
            "fax_number": "262-203-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORN",
        "first_name": "ROBY",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4053-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38958700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.