Active NPI
Andrea Marie Lange, D.C.
- Chiropractor
- Brookfield, WI
National Provider Identifier
1083919724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4626-012
- Practice address
- 16535 W Bluemound Rd
Suite 222
Brookfield, WI 53005-5936 - Phone
- (262) 754-4910
- Fax
- (262) 754-4913
- NPI assigned
- Jan 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4626-012 | WI | Primary |
Addresses
Primary practice location
16535 W Bluemound Rd
Suite 222
Brookfield, WI 53005-5936
Mailing address
16535 W Bluemound Rd
Suite 222
Brookfield, WI 53005-5936
Phone (262) 754-4910
Other names 1
- Andrea Marie Nolte
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4626-012 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kettle Moraine Chiropractic Clinic SC | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- West Bend, WI
- NPI 1174682553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294704000000",
"number": "1083919724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16535 W BLUEMOUND RD",
"address_2": "SUITE 222",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530055936",
"telephone_number": "262-754-4910",
"fax_number": "262-754-4913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16535 W BLUEMOUND RD",
"address_2": "SUITE 222",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530055936",
"telephone_number": "262-754-4910",
"fax_number": "262-754-4913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "ANDREA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-11",
"last_updated": "2011-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "4626-012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "NOLTE",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.