NPIMap

Organization Active NPI

Chiro One Wellness Center of Waukesha, LLC

  • Chiropractor
  • Waukesha, WI
National Provider Identifier
1265806236
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4407-012 Issued in WI
Legal business name
CHIRO ONE WELLNESS CENTER OF WAUKESHA, LLC
Practice address
21075 Swenson Dr Ste 700
Waukesha, WI 53186-2063
Phone
(414) 491-0096
NPI assigned
Nov 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Authorized official

Name
Matthew G Frahm, DCNPI 1801060819
Title
Owner
Phone
(414) 491-0096

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 MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 4407-012 WI Primary

Addresses

Primary practice location

21075 Swenson Dr Ste 700
Waukesha, WI 53186-2063

Mailing address

2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 229-4430

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160209001362 WI Part B Supplier - Clinic/Group Practice 1759685951 Receives reassigned benefits from 5 practitioners
Practice locations: Waukesha, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1265806236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-229-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21075 SWENSON DR STE 700",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862063",
            "telephone_number": "414-491-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF WAUKESHA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2019-08-27",
        "status": "A",
        "authorized_official_last_name": "FRAHM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-491-0096",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4407-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.