Organization Active NPI

Hietpas Chiropractic LLC

  • Chiropractor
  • Sturgeon Bay, WI
National Provider Identifier
1306001904
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2818 Issued in WI
Legal business name
HIETPAS CHIROPRACTIC LLC
Practice address
1444 Egg Harbor Rd
Sturgeon Bay, WI 54235-1240
Phone
(920) 743-2200
Fax
(920) 743-2250
NPI assigned
Jul 23, 2008
Last updated
Jul 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Dr. Cathleen L Hietpas, DC
Title
Business Manager
Phone
(920) 743-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2818 WI Primary

Addresses

Primary practice location

1444 Egg Harbor Rd
Sturgeon Bay, WI 54235-1240

Mailing address

1444 Egg Harbor Rd
Sturgeon Bay, WI 54235-1240
Phone (920) 743-2200

Other identifiers 1

IdentifierTypeStateIssuer
38880000MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090304000846 WI Part B Supplier - Clinic/Group Practice 6901979723 Receives reassigned benefits from 1 practitioner
Practice locations: Sturgeon Bay, WI

National Provider Directory

National Provider Directory

Locations

1444 Egg Harbor Rd
Sturgeon Bay, WI 54235
Phone (920) 743-2200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1306001904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 EGG HARBOR RD",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351240",
            "telephone_number": "920-743-2200",
            "fax_number": "920-743-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 EGG HARBOR RD",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351240",
            "telephone_number": "920-743-2200",
            "fax_number": "920-743-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIETPAS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "HIETPAS",
        "authorized_official_first_name": "CATHLEEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "920-743-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38880000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgeon Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.