Organization Active NPI

Rubert Chiropractic LTD

  • Chiropractor
  • Fall River, WI
National Provider Identifier
1083780670
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3105 Issued in WI
Legal business name
RUBERT CHIROPRACTIC LTD
Practice address
W1185 McCrae Rd
Fall River, WI 53932
Phone
(920) 484-6444
Fax
(920) 484-6450
NPI assigned
Nov 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jill A RubertNPI 1336215920
Title
Owner President
Phone
(920) 484-6444

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 3105 WI Primary

Addresses

Primary practice location

W1185 McCrae Rd
Fall River, WI 53932

Mailing address

W1185 McCrae Rd
Fall River, WI 53932
Phone (920) 484-6444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100421000710 WI Part B Supplier - Clinic/Group Practice 1052448149 Receives reassigned benefits from 4 practitioners
Practice locations: Beaver Dam, WI; Fall River, WI

National Provider Directory

National Provider Directory

Locations

1229 N Center St
Beaver Dam, WI 53916
Phone (920) 219-9322

W1185 McCrae Rd
Fall River, WI 53932
Phone (920) 484-6444

Practitioners & affiliated clinicians

Practitioners 5

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": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083780670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W1185 MCCRAE RD",
            "city": "FALL RIVER",
            "state": "WI",
            "postal_code": "53932",
            "telephone_number": "920-484-6444",
            "fax_number": "920-484-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W1185 MCCRAE RD",
            "city": "FALL RIVER",
            "state": "WI",
            "postal_code": "53932",
            "telephone_number": "920-484-6444",
            "fax_number": "920-484-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBERT CHIROPRACTIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUBERT",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "920-484-6444",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.