Individual provider Active NPI

Scott A Capesius, D.C.

  • Neurology Chiropractor
  • Green Bay, WI
National Provider Identifier
1235294026
Registry record updated Sep 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
3491 Issued in WI
Practice address
850C Lombardi Ave
Green Bay, WI 54304-3768
Phone
(920) 430-7400
Fax
(920) 430-7405
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 3491 WI Primary

Addresses

Primary practice location

850C Lombardi Ave
Green Bay, WI 54304-3768

Mailing address

850C Lombardi Ave
Green Bay, WI 54304-3768
Phone (920) 430-7400

Other identifiers 1

IdentifierTypeStateIssuer
38908200MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111214000762 WI Practitioner - Chiropractic 5698940930 Practice locations: Green Bay, WI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

850 C Lombardi Ave
Green Bay, WI 54304-3768
Phone (920) 430-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3491WIMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348963200000",
    "number": "1235294026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850C LOMBARDI AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543043768",
            "telephone_number": "920-430-7400",
            "fax_number": "920-430-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850C LOMBARDI AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543043768",
            "telephone_number": "920-430-7400",
            "fax_number": "920-430-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPESIUS",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2012-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "WI",
            "license": "3491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38908200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2012; 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.