Active NPI
Dane W McCullough, DC
- Chiropractor
- Germantown, WI
National Provider Identifier
1154849024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5301-12
- Practice address
- N96W19150 County Line Rd
Germantown, WI 53022-4540 - Phone
- (262) 293-4002
- NPI assigned
- Aug 31, 2017
- Sex
- Male
- Sole proprietor
- No
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 | 5301-12 | WI | Primary |
Addresses
Primary practice location
N96W19150 County Line Rd
Germantown, WI 53022-4540
Mailing address
2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 468-1824
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200127000109 | WI | Practitioner - Chiropractic | 7719312420 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CJR Partners LLC | Chiropractor | Past | Accepting new patients |
| Massart Chiropractic SC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
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.
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- NPI 1669616801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578614400000",
"number": "1154849024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 BUTTERFIELD RD STE 301N",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231266",
"telephone_number": "630-468-1824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N96W19150 COUNTY LINE RD",
"city": "GERMANTOWN",
"state": "WI",
"postal_code": "530224540",
"telephone_number": "262-293-4002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "DANE",
"middle_name": "W",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-31",
"last_updated": "2020-01-10",
"certification_date": "2020-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "5301-12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; 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.