NPIMap

Organization Active NPI

Smith Chiropractic and Rehabilitation

  • Rehabilitation Chiropractor
  • Germantown, WI
National Provider Identifier
1093859241
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
2664 Issued in WI
Legal business name
SMITH CHIROPRACTIC AND REHABILITATION
Practice address
W177N9856 Rivercrest Dr
Suite 102
Germantown, WI 53022-4647
Phone
(262) 251-9300
Fax
(262) 251-9303
NPI assigned
Feb 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Dr. Thomas Paul Smith, D.C.NPI 1881658045
Title
Owner
Phone
(262) 251-9300

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
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 2664 WI Primary

Addresses

Primary practice location

W177N9856 Rivercrest Dr
Suite 102
Germantown, WI 53022-4647

Mailing address

W177N9856 Rivercrest Dr
Suite 102
Germantown, WI 53022-4647
Phone (262) 251-9300

Other identifiers 3

IdentifierTypeStateIssuer
DB5091OtherWIRAILROAD MEDICARE
P00110391OtherWIRAILROAD MEDICARE
200879351018OtherWIBLUE CROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1093859241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W177N9856 RIVERCREST DR",
            "address_2": "SUITE 102",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224647",
            "telephone_number": "262-251-9300",
            "fax_number": "262-251-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W177N9856 RIVERCREST DR",
            "address_2": "SUITE 102",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224647",
            "telephone_number": "262-251-9300",
            "fax_number": "262-251-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH CHIROPRACTIC AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-251-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WI",
            "license": "2664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB5091",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00110391",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "200879351018",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.