Individual provider Active NPI

Bradley H Wehking, D.C.

  • Chiropractor
  • Watertown, WI
National Provider Identifier
1306834130
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3149 Issued in WI
Practice address
816 West St
Watertown, WI 53094-3608
Phone
(920) 262-0200
Fax
(920) 262-0210
NPI assigned
Oct 6, 2005
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3149 WI Primary

Addresses

Primary practice location

816 West St
Watertown, WI 53094-3608

Mailing address

816 West St
Watertown, WI 53094-3608
Phone (920) 262-0200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101008001048 WI Practitioner - Chiropractic 1456414671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

816 W St
Watertown, WI 53094-1201
Phone (920) 262-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3149WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Chiropractic Center LLC Chiropractor CurrentSince Aug 26, 2002 Accepting new patients
Luedtke-Storm-Mackey Chiropractic Clinic SC Chiropractor PastSince Nov 13, 2022 Accepting new patients

Locations

816 West St
Watertown, WI 53094
Phone (920) 262-0200

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1306834130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 WEST ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530943608",
            "telephone_number": "920-262-0200",
            "fax_number": "920-262-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 WEST ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530943608",
            "telephone_number": "920-262-0200",
            "fax_number": "920-262-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEHKING",
        "first_name": "BRADLEY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.