Individual provider Active NPI

Randall L Blohowiak, DC

  • Chiropractor
  • Neenah, WI
National Provider Identifier
1356301188
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2757 Issued in WI
Practice address
1031 Northcreek Dr
Neenah, WI 54956-5651
Phone
(920) 810-4526
Fax
(920) 324-9898
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2757 WI Primary

Addresses

Primary practice location

1031 Northcreek Dr
Neenah, WI 54956-5651

Mailing address

1031 Northcreek Dr
Neenah, WI 54956
Phone (920) 810-4526

Other identifiers 3

IdentifierTypeStateIssuer
38861600MedicaidWI
350056712OtherWIRAILROAD MEDICARE
14376OtherWIDEAN CARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050928000348 WI Practitioner - Chiropractic 1052346202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Medical Center, S.C.Group PAC ID 8022440973, 5 clinicians

Practice addresses (Care Compare)

160 Gateway Dr
Waupun, WI 53963-2276
Phone (920) 324-9899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2757WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Medical Center, S.C. CurrentSince Jun 24, 2019 Accepting new patients
Wound Care of Wisconsin LLC CurrentSince Nov 1, 2024 Accepting new patients
Massart Chiropractic SC Chiropractor PastSince Oct 3, 2008 Accepting new patients

Locations

160 Gateway Dr
Ste A
Waupun, WI 53963
Phone (920) 324-9899

160 Gateway Dr
Waupun, WI 53963
Phone (920) 324-9899

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1356301188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 NORTHCREEK DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "54956",
            "telephone_number": "920-810-4526",
            "fax_number": "920-324-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 NORTHCREEK DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549565651",
            "telephone_number": "920-810-4526",
            "fax_number": "920-324-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOHOWIAK",
        "first_name": "RANDALL",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38861600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350056712",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN CARE",
            "identifier": "14376",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.