Individual provider Active NPI

Ellen Maureen Sauer-Draeger, DC

  • Chiropractor
  • Antigo, WI
National Provider Identifier
1104853977
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3137012 Issued in WI
Practice address
239 Superior Street
Antigo, WI 54409-1860
Phone
(715) 623-4800
Fax
(715) 623-6466
NPI assigned
Jun 27, 2006
Sex
Female
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 3137012 WI Primary

Addresses

Primary practice location

239 Superior Street
Antigo, WI 54409-1860

Mailing address

239 Superior Street
Antigo, WI 54409-1860
Phone (715) 623-4800

Other identifiers 1

IdentifierTypeStateIssuer
38883700MedicaidWI

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

LicenseStateTypeSpecialty
5789MNMDClinical Psychologist
3137012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Draeger Chiropractic Clinic, S.C. Chiropractor PastSince Apr 1, 1997 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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104853977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 SUPERIOR STREET",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544091860",
            "telephone_number": "715-623-4800",
            "fax_number": "715-623-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 SUPERIOR STREET",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544091860",
            "telephone_number": "715-623-4800",
            "fax_number": "715-623-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUER-DRAEGER",
        "first_name": "ELLEN",
        "middle_name": "MAUREEN",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3137012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38883700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antigo, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.