Eric Boettcher, S.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4106 Issued in WI

Legal business name

ERIC BOETTCHER, S.C.

Doing business as

Redgranite Family Chiropractic

Practice address

620 Warren St # 1
Redgranite, WI 54970-9391

Phone

(920) 566-0767

Fax

(920) 566-0768

NPI assigned

Sep 20, 2006

Last updated

Jan 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eric S Boettcher, D.C.NPI 1750306957

Title

Chiropractor

Phone

(920) 566-0767

Specialties & licenses 1

Addresses

Other names 1

• Redgranite Family Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric Steven Boettcher, D.C.

  • Chiropractor
  • Redgranite, WI
  • NPI 1750306957
  Medicare reassignment NPD Authorized official
• Lori Augusta Larsen, MESSAGE THERAPIST

  • Massage Therapist
  • Redgranite, WI
  • NPI 1598427833
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1245337559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 447",
            "city": "REDGRANITE",
            "state": "WI",
            "postal_code": "549700447",
            "telephone_number": "920-566-0767",
            "fax_number": "920-566-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WARREN ST # 1",
            "city": "REDGRANITE",
            "state": "WI",
            "postal_code": "549709391",
            "telephone_number": "920-566-0767",
            "fax_number": "920-566-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC BOETTCHER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "BOETTCHER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "920-566-0767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redgranite Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Steven Boettcher, D.C.
• Cierria Victoria Bretzel, DNP
• Nicole Burkhalter, RDN, CD, LD
• Community Healt Network (CHN Medical Center - Redgranite)
• Robert B Devermann, MD
• Terry L Hankey, MD
• Christine Hohenstein, RN
• Charles Albert Huibregtse, MD PHD
• Lori Augusta Larsen, MESSAGE THERAPIST
• Craig Dennis Maskil, MD

• Chiropractor in Redgranite, WI
• Providers in Redgranite, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.