Individual provider Active NPI

William Joseph Bredael, B.S., D.C.

  • Chiropractor
  • Luxemburg, WI
National Provider Identifier
1285696302
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4087-012 Issued in WI
Practice address
195 Center Dr
Suite 102
Luxemburg, WI 54217-8395
Phone
(920) 845-5569
Fax
(920) 845-5568
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4087-012 WI Primary

Addresses

Primary practice location

195 Center Dr
Suite 102
Luxemburg, WI 54217-8395

Mailing address

195 Center Dr
Suite 102
Luxemburg, WI 54217-8395
Phone (920) 845-5569

Other identifiers 1

IdentifierTypeStateIssuer
38957600MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050118000394 WI Practitioner - Chiropractic 8820047863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

195 Ctr Dr
Suite 102
Luxemburg, WI 54217-8395
Phone (920) 845-5569

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
4087-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bredael Family Chiropractic Chiropractor CurrentSince Oct 15, 2008 Accepting new patients
Luxemburg Family Chiropractic, SC Chiropractor Past Accepting new patients
Kirchman Chiropractic, LLC Chiropractor PastSince Feb 1, 2005 Accepting new patients

Locations

195 Center Dr
Ste 102
Luxemburg, WI 54217
Phone (920) 845-5569

Organizations & group practices 3

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1285696302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 CENTER DR",
            "address_2": "SUITE 102",
            "city": "LUXEMBURG",
            "state": "WI",
            "postal_code": "542178395",
            "telephone_number": "920-845-5569",
            "fax_number": "920-845-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 CENTER DR",
            "address_2": "SUITE 102",
            "city": "LUXEMBURG",
            "state": "WI",
            "postal_code": "542178395",
            "telephone_number": "920-845-5569",
            "fax_number": "920-845-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDAEL",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "B.S., D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4087-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38957600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Luxemburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.

Verify at the official NPI Registry.