Active NPI
Bay Area Chiropractic SC
- Chiropractor
- Green Bay, WI
National Provider Identifier
1104804012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Legal business name
- BAY AREA CHIROPRACTIC SC
- Practice address
- 1441 Bellevue St
Green Bay, WI 54311-5605 - Phone
- (920) 468-1963
- Fax
- (920) 468-9785
- NPI assigned
- Jan 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert A Servais Jr., DC
- Title
- Owner
- Phone
- (920) 468-1963
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | Primary |
Addresses
Primary practice location
1441 Bellevue St
Green Bay, WI 54311-5605
Mailing address
1441 Bellevue St
Green Bay, WI 54311-5605
Phone (920) 468-1963
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39001100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041105000042 | WI | Part B Supplier - Clinic/Group Practice | 2860455417 |
Receives reassigned benefits from 3 practitioners Practice locations: Green Bay, WI |
National Provider Directory
National Provider DirectoryLocations
1441 Bellevue St
Green Bay, WI 54311
Phone (920) 465-7772
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Green Bay, WI
- NPI 1811711187
-
- Chiropractor
- Green Bay, WI
- NPI 1104786359
-
- Chiropractor
- Green Bay, WI
- NPI 1144301078
-
- Chiropractor
- Green Bay, WI
- NPI 1871572321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136246400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1755648000000",
"number": "1104804012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1441 BELLEVUE ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543115605",
"telephone_number": "920-468-1963",
"fax_number": "920-468-9785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1441 BELLEVUE ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543115605",
"telephone_number": "920-468-1963",
"fax_number": "920-468-9785"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAY AREA CHIROPRACTIC SC",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-03",
"last_updated": "2025-08-20",
"certification_date": "2025-08-08",
"status": "A",
"authorized_official_last_name": "SERVAIS",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "920-468-1963",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39001100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.