Active NPI
Kurt Rodney Wipperfurth, D,C,
- Chiropractor
- Green Bay, WI
National Provider Identifier
1124118682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3111
- Practice address
- 1281 S. Brosig Street
Suite B
Green Bay, WI 54311 - Phone
- (920) 965-0441
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3111 | WI | Primary |
Addresses
Primary practice location
1281 S. Brosig Street
Suite B
Green Bay, WI 54311
Mailing address
1281 S. Brosig Street
Suite B
Green Bay, WI 54311
Phone (920) 965-0441
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38879100 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3111 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Applied Khiropractic, LLC | Chiropractor | Past | 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.
-
- Chiropractor
- Green Bay, WI
- NPI 1326101783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1124118682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1281 S. BROSIG STREET",
"address_2": "SUITE B",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54311",
"telephone_number": "920-965-0441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1281 S. BROSIG STREET",
"address_2": "SUITE B",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54311",
"telephone_number": "920-965-0441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIPPERFURTH",
"first_name": "KURT",
"middle_name": "RODNEY",
"credential": "D,C,",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "3111",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38879100",
"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 Jul 9, 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.