Organization Active NPI

Nelson-Sivret Chiropractic, LLC

  • Chiropractor
  • Kewaunee, WI
National Provider Identifier
1225186547
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NELSON-SIVRET CHIROPRACTIC, LLC
Practice address
402 Ellis St
Kewaunee, WI 54216-1329
Phone
(920) 388-4499
Fax
(920) 388-4499
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Authorized official

Name
Dr. Charles Leslie Sivret, D.C.
Title
Manager
Phone
(920) 388-4499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X WI Primary

Addresses

Primary practice location

402 Ellis St
Kewaunee, WI 54216-1329

Mailing address

402 Ellis St
Kewaunee, WI 54216-1329
Phone (920) 388-4499

Other identifiers 1

IdentifierTypeStateIssuer
38736500MedicaidWI

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": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1225186547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 ELLIS ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161329",
            "telephone_number": "920-388-4499",
            "fax_number": "920-388-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 ELLIS ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161329",
            "telephone_number": "920-388-4499",
            "fax_number": "920-388-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON-SIVRET CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "SIVRET",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "920-388-4499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38736500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kewaunee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.