NPIMap

Organization Active NPI

Kinderman Family Chiropractic Incorporated

  • Chiropractor
  • Hudson, WI
National Provider Identifier
1154626463
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4652-12 Issued in WI
Legal business name
KINDERMAN FAMILY CHIROPRACTIC INCORPORATED
Practice address
2217 Vine St
Suite 102
Hudson, WI 54016-5863
Phone
(715) 386-0833
Fax
(715) 386-0833
NPI assigned
Jan 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Authorized official

Name
Dr. Benjamin Robert Kinderman, D.C.NPI 1063727733
Title
Chiropractor/President/Co Owner
Phone
(715) 386-0833

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 4652-12 WI Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 4655-12 WI

Addresses

Primary practice location

2217 Vine St
Suite 102
Hudson, WI 54016-5863

Mailing address

2217 Vine Street
Suite 102
Hudson, WI 54016
Phone (715) 386-0833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110125000067 WI Part B Supplier - Clinic/Group Practice 8426237306 Receives reassigned benefits from 2 practitioners
Practice locations: Hudson, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1295308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1154626463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 VINE STREET",
            "address_2": "SUITE 102",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "54016",
            "telephone_number": "715-386-0833",
            "fax_number": "715-386-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 VINE ST",
            "address_2": "SUITE 102",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540165863",
            "telephone_number": "715-386-0833",
            "fax_number": "715-386-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDERMAN FAMILY CHIROPRACTIC INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-18",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "KINDERMAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CHIROPRACTOR/PRESIDENT/CO OWNER",
        "authorized_official_telephone_number": "715-386-0833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4652-12",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4655-12",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jan 18, 2011; 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.