Individual provider Active NPI

Joe Alan Dirker, D.C.

  • Chiropractor
  • Sheboygan, WI
National Provider Identifier
1356340418
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3361 Issued in WI
Practice address
909 S Taylor Dr
Sheboygan, WI 53081-4766
Phone
(920) 451-7000
Fax
(920) 451-7100
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3361 WI Primary

Addresses

Primary practice location

909 S Taylor Dr
Sheboygan, WI 53081-4766

Mailing address

909 S Taylor Dr
Sheboygan, WI 53081-4766
Phone (920) 451-7000

Other identifiers 1

IdentifierTypeStateIssuer
38939900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031204000131 WI Practitioner - Chiropractic 0446155477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dirker Chiropractic LLCGroup PAC ID 8820993850, 5 clinicians

Practice addresses (Care Compare)

707 S Taylor Dr
Sheboygan, WI 53081-4278
Phone (920) 451-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3361WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dirker Chiropractic LLC Chiropractor CurrentSince Sep 29, 2003 Accepting new patients

Locations

909 S Taylor Dr
Sheboygan, WI 53081
Phone (920) 451-7000

707 S Taylor Dr
Sheboygan, WI 53081
Phone (920) 451-7000

Organizations & group practices 1

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1356340418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 S TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814766",
            "telephone_number": "920-451-7000",
            "fax_number": "920-451-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814766",
            "telephone_number": "920-451-7000",
            "fax_number": "920-451-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRKER",
        "first_name": "JOE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38939900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.