Carli Marie Vangoethem, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5778-12 Issued in WI

Practice address

402 Ellis St
Kewaunee, WI 54216-1329

Phone

(920) 388-4499

NPI assigned

May 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Root of Wellness Chiropractic LLC

  • Chiropractor
  • Kewaunee, WI
  • NPI 1972290500
  Medicare reassignment NPD Authorized official
• Nelson-Sivret Chiropractic, LLC

  • Chiropractor
  • Kewaunee, WI
  • NPI 1225186547
  NPD
• Kellie K. Hoover, DC, PC

  • Chiropractor
  • Des Moines, IA
  • NPI 1942447552
  NPD

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1306583687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 ELLIS ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161329",
            "telephone_number": "920-621-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 ELLIS ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161329",
            "telephone_number": "920-388-4499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Ingersoll Ave",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503093321",
            "country_code": "US",
            "telephone_number": "515-225-2237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANGOETHEM",
        "first_name": "CARLI",
        "middle_name": "MARIE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "114461",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "WI",
            "license": "5778-12",
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "WI",
            "license": "5778-12",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5778-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis
• Marcus Arnold Steele, DC
• Carol Elaine Stuebs, ES EDUCATION
• Karen K Treml, MST SLP CCC
• Joanne Lee Tulachka, CSAC
• Teresa M Vanlanen, OT
• Kristin Lynn Veleke, MED
• Kaitlyn Marie Villalpando, LPC
• Daniel G Vincent, DIRECT CARE FOR SPEC
• Laurie S Wegner-Burns, NP

• Chiropractor in Kewaunee, WI
• Providers in Kewaunee, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.