Individual provider Active NPI

Ib Thostrup, D.C.

  • Chiropractor
  • Racine, WI
National Provider Identifier
1114071917
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2351 Issued in WI
Practice address
2827 Rapids Dr
Racine, WI 53404-1620
Phone
(262) 633-3123
Fax
(262) 633-4823
NPI assigned
Jan 22, 2007
Last updated
Mar 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2351 WI Primary

Addresses

Primary practice location

2827 Rapids Dr
Racine, WI 53404-1620

Mailing address

2827 Rapids Dr
Racine, WI 53404-1620
Phone (262) 633-3123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090421000459 WI Practitioner - Chiropractic 0547317042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2827 Rapids Dr
Racine, WI 53404-1620
Phone (262) 633-3123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thostrup Chiropractic, S.C. Chiropractor CurrentSince Jun 2, 1989 Accepting new patients

Locations

2827 Rapids Dr
Racine, WI 53404
Phone (262) 633-3123

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1114071917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 RAPIDS DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534041620",
            "telephone_number": "262-633-3123",
            "fax_number": "262-633-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 RAPIDS DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534041620",
            "telephone_number": "262-633-3123",
            "fax_number": "262-633-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOSTRUP",
        "first_name": "IB",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.