Organization Active NPI

Trinity Chiropractic Health Center LLC

  • Chiropractor
  • Hudson, WI
National Provider Identifier
1144719121
Registry record updated May 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5344-12 Issued in WI
Legal business name
TRINITY CHIROPRACTIC HEALTH CENTER LLC
Practice address
1830 Webster St Ste 130
Hudson, WI 54016-9321
Phone
(715) 459-7096
NPI assigned
May 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2018

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

Authorized official

Name
Stormie Reiman, DCNPI 1538512686
Title
Doctor of Chiropractic
Phone
(715) 459-7096

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)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5344-12 WI Primary

Addresses

Primary practice location

1830 Webster St Ste 130
Hudson, WI 54016-9321

Mailing address

1830 Webster St Ste 130
Hudson, WI 54016-9321
Phone (715) 459-7096

Other identifiers 1

IdentifierTypeStateIssuer
1538512686MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181017002381 WI Part B Supplier - Clinic/Group Practice 1850643974 Receives reassigned benefits from 1 practitioner
Practice locations: Hudson, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525564800000",
    "number": "1144719121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 WEBSTER ST STE 130",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169321",
            "telephone_number": "715-459-7096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 WEBSTER ST STE 130",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169321",
            "telephone_number": "715-459-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY CHIROPRACTIC HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-06",
        "last_updated": "2018-05-06",
        "status": "A",
        "authorized_official_last_name": "REIMAN",
        "authorized_official_first_name": "STORMIE",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "715-459-7096",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5344-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538512686",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2018; 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.

Verify at the official NPI Registry.