Organization Active NPI

Tomah Chiropractic Clinic

  • Chiropractor
  • Tomah, WI
National Provider Identifier
1083909253
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4478-12 Issued in WI
Legal business name
TOMAH CHIROPRACTIC CLINIC
Practice address
500 N Superior Ave
Tomah, WI 54660-1114
Phone
(608) 372-3348
NPI assigned
Jun 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Authorized official

Name
Lindsey ShawNPI 1780823641
Title
Owner/Chiropractor
Phone
(608) 372-3348

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4478-12 WI Primary

Addresses

Primary practice location

500 N Superior Ave
Tomah, WI 54660-1114

Mailing address

PO Box 937
500 N. Superior Ave.
Tomah, WI 54660-0937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110706000096 WI Part B Supplier - Clinic/Group Practice 4284812785 Receives reassigned benefits from 1 practitioner
Practice locations: Tomah, WI

National Provider Directory

National Provider Directory

Locations

500 N Superior Ave
Tomah, WI 54660
Phone (608) 372-3348

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1083909253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 937",
            "address_2": "500 N. SUPERIOR AVE.",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546600937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N SUPERIOR AVE",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601114",
            "telephone_number": "608-372-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMAH CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "608-372-3348"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4478-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.