Roger Clarence Hasbrouck, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1570 Issued in WI

Practice address

915 Madison St
Beaver Dam, WI 53916-2623

Phone

(920) 887-8436

Fax

(920) 887-7399

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1083796643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 MADISON ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162623",
            "telephone_number": "920-887-8436",
            "fax_number": "920-887-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MADISON ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162623",
            "telephone_number": "920-887-8436",
            "fax_number": "920-887-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASBROUCK",
        "first_name": "ROGER",
        "middle_name": "CLARENCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38764000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "391363647010",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rolf H Hansen, DPM
• Shaylie Hansen, SAC-IT
• Elizabeth A Hansmann, LAT
• Linda Kay Hanson, DPT
• Jill Harkins
• Rachel Hau
• Charles Paul Hendrix, OD
• Jawana Hendrix
• Chancelor Lucas Hernandez, MA, ATC, LAT
• Teresa Mary Hill, RD

• Chiropractor in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.