Individual provider Active NPI

Sara Jane Rubert, DC

  • Chiropractor
  • Fall River, WI
National Provider Identifier
1154497741
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3692012 Issued in WI
Practice address
W1185 McCrae Rd
Fall River, WI 53932-9575
Phone
(920) 484-6444
Fax
(920) 484-6450
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3692012 WI Primary

Addresses

Primary practice location

W1185 McCrae Rd
Fall River, WI 53932-9575

Mailing address

W1185 McCrae Rd
Fall River, WI 53932
Phone (920) 484-6444

Other identifiers 1

IdentifierTypeStateIssuer
350049198OtherRRMC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000200 WI Practitioner - Chiropractic 2961533658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Rubert Chiropractic LTDGroup PAC ID 1052448149, 4 clinicians

Practice addresses (Care Compare)

W1185 McCrae Rd
Fall River, WI 53932-9575
Phone (920) 484-6444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3692012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rubert Chiropractic LTD Chiropractor CurrentSince Oct 26, 2000 Accepting new patients

Locations

W1185 McCrae Rd
Fall River, WI 53932
Phone (920) 484-6444

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1154497741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W1185 MCCRAE RD",
            "city": "FALL RIVER",
            "state": "WI",
            "postal_code": "53932",
            "telephone_number": "920-484-6444",
            "fax_number": "920-484-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W1185 MCCRAE RD",
            "city": "FALL RIVER",
            "state": "WI",
            "postal_code": "539329575",
            "telephone_number": "920-484-6444",
            "fax_number": "920-484-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBERT",
        "first_name": "SARA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3692012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "350049198",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.