Active NPI
Dennis J King, DC, CCSP, FACO
- Chiropractor
- Green Bay, WI
National Provider Identifier
1255411302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2312
- Practice address
- 721 Cardinal LN
Suite 100
Green Bay, WI 54313-3216 - Phone
- (920) 434-2221
- Fax
- (920) 434-2483
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2312 | WI | Primary |
Addresses
Primary practice location
721 Cardinal LN
Suite 100
Green Bay, WI 54313-3216
Mailing address
PO Box 11067
Green Bay, WI 54307-1067
Phone (920) 434-2221
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38840100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
721 Cardinal LN
Suite 100
Green Bay, WI 54313-3216
Phone (920) 434-2221
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Howard Chiropractic Clinic, S.C. | Current | Accepting new patients | |
| Employment Health Services, LLC | Past | Accepting new patients |
Locations
721 Cardinal Ln
Ste 100
Green Bay, WI 54313
Phone (920) 434-2221
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopedic Chiropractor
- Green Bay, WI
- NPI 1831363431
-
- Clinical Medical Laboratory
- Green Bay, WI
- NPI 1811203367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355097600000",
"number": "1255411302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11067",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543071067",
"telephone_number": "920-434-2221",
"fax_number": "920-434-2483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 CARDINAL LN",
"address_2": "SUITE 100",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543133216",
"telephone_number": "920-434-2221",
"fax_number": "920-434-2483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "DENNIS",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "DC, CCSP, FACO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2012-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "2312",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38840100",
"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 Dec 10, 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.