NPIMap

Organization Active NPI

Chiropractic Health and Wellness Center of Wautoma, Inc

  • Chiropractor
  • Wautoma, WI
National Provider Identifier
1215018916
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4769 Issued in WI
Legal business name
CHIROPRACTIC HEALTH AND WELLNESS CENTER OF WAUTOMA, INC
Practice address
200 N Oakridge CT
Wautoma, WI 54982-8405
Phone
(920) 787-4715
Fax
(920) 787-1083
NPI assigned
Oct 18, 2006
Last updated
Oct 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Dr. Nathan L Barkalow, DCNPI 1336421346
Title
Owner
Phone
(920) 787-4715

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
Chiropractor 111N00000X 4769 WI Primary

Addresses

Primary practice location

200 N Oakridge CT
Wautoma, WI 54982-8405

Mailing address

200 N Oakridge CT
Wautoma, WI 54982-8405
Phone (920) 787-4715

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161028001136 WI Part B Supplier - Clinic/Group Practice 8921386772 Receives reassigned benefits from 1 practitioner
Practice locations: Wautoma, WI

National Provider Directory

National Provider Directory

Locations

200 N Oakridge Ct
Wautoma, WI 54982
Phone (920) 787-4715

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1215018916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N OAKRIDGE CT",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549828405",
            "telephone_number": "920-787-4715",
            "fax_number": "920-787-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N OAKRIDGE CT",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549828405",
            "telephone_number": "920-787-4715",
            "fax_number": "920-787-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC HEALTH AND WELLNESS CENTER OF WAUTOMA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "BARKALOW",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-787-4715",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wautoma, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.