Organization Active NPI

New Berlin Chiropractic and Therapy Center SC

  • Chiropractor
  • New Berlin, WI
National Provider Identifier
1205915568
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NEW BERLIN CHIROPRACTIC AND THERAPY CENTER SC
Practice address
15800 W National Ave
New Berlin, WI 53151-5121
Phone
(262) 785-8989
Fax
(262) 785-8992
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Paul Koshick, D.C.NPI 1518964394
Title
President
Phone
(262) 785-8989

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 MULTIPLE SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

15800 W National Ave
New Berlin, WI 53151-5121

Mailing address

15800 W National Ave
New Berlin, WI 53151-5121
Phone (262) 785-8989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050221000460 WI Part B Supplier - Clinic/Group Practice 3173575958 Receives reassigned benefits from 1 practitioner
Practice locations: New Berlin, WI

National Provider Directory

National Provider Directory

Locations

15800 W National Ave
New Berlin, WI 53151
Phone (262) 785-8989

Practitioners & affiliated clinicians

Practitioners 3

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": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205915568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15800 W NATIONAL AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531515121",
            "telephone_number": "262-785-8989",
            "fax_number": "262-785-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 W NATIONAL AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531515121",
            "telephone_number": "262-785-8989",
            "fax_number": "262-785-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BERLIN CHIROPRACTIC AND THERAPY CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOSHICK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-785-8989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.