Individual provider Active NPI

Kelly G. Von-Schilling Worth, DC, FIACN, DACAN

  • Neurology Chiropractor
  • Mount Pleasant, WI
National Provider Identifier
1285703710
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
4264-12 Issued in WI
Practice address
6211 Durand Ave
Suite #100
Mount Pleasant, WI 53406
Phone
(262) 898-9000
NPI assigned
Nov 7, 2006
Last updated
Jun 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 038-010349 IL
Neurology Chiropractor 111NN0400X 4264-12 WI Primary

Addresses

Primary practice location

6211 Durand Ave
Suite #100
Mount Pleasant, WI 53406

Mailing address

PO Box 44415
Racine, WI 53404-7008
Phone (262) 770-7014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121108000650 WI Practitioner - Chiropractic 7012168578 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010349ILMDNeurology Chiropractor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1285703710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44415",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534047008",
            "telephone_number": "262-770-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 DURAND AVE",
            "address_2": "SUITE #100",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "53406",
            "telephone_number": "262-898-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON-SCHILLING WORTH",
        "first_name": "KELLY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DC, FIACN, DACAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "IL",
            "license": "038-010349",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "WI",
            "license": "4264-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.