Individual provider Active NPI

Matthew Thomas McNally, D.C.

  • Chiropractor
  • Tomah, WI
National Provider Identifier
1093862187
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3654-012 Issued in WI
Practice address
1021 N Superior Ave
Ste 9
Tomah, WI 54660-1100
Phone
(608) 372-5900
Fax
(608) 372-5800
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3654-012 WI Primary

Addresses

Primary practice location

1021 N Superior Ave
Ste 9
Tomah, WI 54660-1100

Mailing address

1021 N Superior Ave
Ste 9
Tomah, WI 54660-1100
Phone (608) 372-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120605000625 WI Practitioner - Chiropractic 5496745994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McNally Spinal Care LLCGroup PAC ID 4789674268, 4 clinicians

Practice addresses (Care Compare)

1021 Berry Ave
Tomah, WI 54660-3400
Phone (608) 372-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3654-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093862187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N SUPERIOR AVE",
            "address_2": "STE 9",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601100",
            "telephone_number": "608-372-5900",
            "fax_number": "608-372-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N SUPERIOR AVE",
            "address_2": "STE 9",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601100",
            "telephone_number": "608-372-5900",
            "fax_number": "608-372-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNALLY",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3654-012",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.