Organization Active NPI

Sussex Chiropractic SC

  • Chiropractor
  • Sussex, WI
National Provider Identifier
1245457050
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2291 Issued in WI
Legal business name
SUSSEX CHIROPRACTIC SC
Practice address
N64 W22640 Main Street
Sussex, WI 53089
Phone
(262) 246-8811
Fax
(262) 246-8894
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Daniel Loftus, DCNPI 1215914387
Title
Owner
Phone
(262) 246-8811

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2291 WI Primary

Addresses

Primary practice location

N64 W22640 Main Street
Sussex, WI 53089

Mailing address

N64 W22640 Main Street
Sussex, WI 53089
Phone (262) 246-8811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071115000390 WI Part B Supplier - Clinic/Group Practice 4688762206 Receives reassigned benefits from 1 practitioner
Practice locations: Sussex, 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": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245457050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N64 W22640 MAIN STREET",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "53089",
            "telephone_number": "262-246-8811",
            "fax_number": "262-246-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N64 W22640 MAIN STREET",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "53089",
            "telephone_number": "262-246-8811",
            "fax_number": "262-246-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSSEX CHIROPRACTIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOFTUS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-246-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sussex, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.