Individual provider Active NPI

Joel David Kirchberg, D.C.

  • Chiropractor
  • Columbus, WI
National Provider Identifier
1235181975
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3989-012 Issued in WI
Practice address
1235 Park Ave
Columbus, WI 53925-1612
Phone
(920) 623-2610
NPI assigned
May 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3989-012 WI Primary

Addresses

Primary practice location

1235 Park Ave
Columbus, WI 53925-1612

Mailing address

PO Box 326
Columbus, WI 53925-0326
Phone (920) 623-2610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060711000056 WI Practitioner - Chiropractic 2567475791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1434 E Main St
Watertown, WI 53094-4035
Phone (920) 261-5607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3989-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Chiropractic, S.C. Chiropractor CurrentSince Jan 7, 2009 Accepting new patients
Family Chiropractic Clinic Inc Chiropractor PastSince Oct 1, 2005 Accepting new patients
Parkside Chiropractic LTD Chiropractor PastSince Jun 12, 2007 Accepting new patients

Locations

1434 E Main St
Watertown, WI 53094
Phone (920) 261-5607

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235181975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539250326",
            "telephone_number": "920-623-2610",
            "fax_number": "920-623-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251612",
            "telephone_number": "920-623-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCHBERG",
        "first_name": "JOEL",
        "middle_name": "DAVID",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3989-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.