Organization Active NPI

Renewed Health Family Chiropractic LLC

  • Occupational Health Chiropractor
  • New Berlin, WI
National Provider Identifier
1215499397
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
Legal business name
RENEWED HEALTH FAMILY CHIROPRACTIC LLC
Practice address
16645 W Greenfield Ave Ste D
New Berlin, WI 53151-1546
Phone
(262) 788-5940
NPI assigned
Apr 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Authorized official

Name
Emily Johanna Johnson, DCNPI 1477086486
Title
Chiropractor
Phone
(262) 903-1360

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
Occupational Health ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NX0100X Primary

Addresses

Primary practice location

16645 W Greenfield Ave Ste D
New Berlin, WI 53151-1546

Mailing address

N7004 County Road O
Elkhorn, WI 53121-2827
Phone (262) 903-1360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190509001691 WI Part B Supplier - Clinic/Group Practice 5698018893 Receives reassigned benefits from 1 practitioner
Practice locations: New Berlin, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1554422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1215499397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N7004 COUNTY ROAD O",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531212827",
            "telephone_number": "262-903-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16645 W GREENFIELD AVE STE D",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531511546",
            "telephone_number": "262-788-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED HEALTH FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "JOHANNA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "262-903-1360",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Occupational Health",
            "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 Apr 5, 2019; 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.