Individual provider Active NPI

Eric Richard Clausen, DC

  • Chiropractor
  • Hortonville, WI
National Provider Identifier
1215037692
Registry record updated Nov 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3935 Issued in WI
Practice address
223 North Pine St
PO Box 187
Hortonville, WI 54944
Phone
(920) 779-3300
Fax
(920) 779-3301
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3935-12 WI
Chiropractor 111N00000X 3935 WI Primary

Addresses

Primary practice location

223 North Pine St
PO Box 187
Hortonville, WI 54944

Mailing address

223 N. Pine St
PO Box 187
Hortonville, WI 54944-9140
Phone (920) 779-3300

Other identifiers 1

IdentifierTypeStateIssuer
38964700MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040323000850 WI Practitioner - Chiropractic 4981595568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

223 N Pine St
Hortonville, WI 54944-9140
Phone (920) 779-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Chiropractic of Hortonville LLC Chiropractor CurrentSince Jun 19, 2017 Accepting new patients
Family Chiropractors Inc Chiropractor PastSince Dec 1, 2001 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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1215037692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N. PINE ST",
            "address_2": "PO BOX 187",
            "city": "HORTONVILLE",
            "state": "WI",
            "postal_code": "549449140",
            "telephone_number": "920-779-3300",
            "fax_number": "920-779-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 NORTH PINE ST",
            "address_2": "PO BOX 187",
            "city": "HORTONVILLE",
            "state": "WI",
            "postal_code": "54944",
            "telephone_number": "920-779-3300",
            "fax_number": "920-779-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAUSEN",
        "first_name": "ERIC",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3935-12",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38964700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hortonville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.