Individual provider Active NPI

Nathan James Omick, D.C.

  • Chiropractor
  • Oconomowoc, WI
National Provider Identifier
1255412185
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4184 Issued in WI
Practice address
N58W39799 W Highway 16
Oconomowoc, WI 53066
Phone
(262) 567-4497
Fax
(262) 567-3716
NPI assigned
Oct 18, 2006
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 4184 WI Primary

Addresses

Primary practice location

N58W39799 W Highway 16
Oconomowoc, WI 53066

Mailing address

PO Box 221
Oconomowoc, WI 53066-0221
Phone (262) 567-4497

Other identifiers 1

IdentifierTypeStateIssuer
38967300MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060322000250 WI Practitioner - Chiropractic 5294743993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael R Traub D.C. LTDGroup PAC ID 0840206363, 3 clinicians

Practice addresses (Care Compare)

N58W39799 Hwy 16
Oconomowoc, WI 53066-2194
Phone (262) 567-4497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4184WIMDSpeech-Language Pathologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255412185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530660221",
            "telephone_number": "262-567-4497",
            "fax_number": "262-567-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N58W39799 W HIGHWAY 16",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "53066",
            "telephone_number": "262-567-4497",
            "fax_number": "262-567-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMICK",
        "first_name": "NATHAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38967300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, 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.