Cardinal Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5080-12 Issued in WI

Legal business name

CARDINAL CHIROPRACTIC LLC

Practice address

E101 4TH St
Brodhead, WI 53520-2003

Phone

(608) 897-3010

Fax

(608) 897-3011

NPI assigned

Jan 16, 2013

Organization subpart

No

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

Authorized official

Name

Travis John Malott, DCNPI 1235521360

Title

Owner

Phone

(608) 897-3010

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• Wilke Chiropractic Office Doing business as
• Travis Malott Holdings LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Travis Malott, D.C.

  • Chiropractor
  • Brodhead, WI
  • NPI 1235521360
  Medicare reassignment Authorized official
• Megan Scheurell, D.C.

  • Chiropractor
  • Evansville, WI
  • NPI 1417402678
  NPD
• Peter J Wilke, DC

  • Chiropractor
  • Evansville, WI
  • NPI 1134289242
  NPD

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1366780918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E101 4TH ST",
            "city": "BRODHEAD",
            "state": "WI",
            "postal_code": "535202003",
            "telephone_number": "608-897-3010",
            "fax_number": "608-897-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E101 4TH ST",
            "city": "BRODHEAD",
            "state": "WI",
            "postal_code": "535202003",
            "telephone_number": "608-897-3010",
            "fax_number": "608-897-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-16",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "MALOTT",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-897-3010",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5080-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "534673",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38941900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilke Chiropractic Office",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Travis Malott Holdings LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Kimberlee Delorme
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• Chiropractor in Brodhead, WI
• Providers in Brodhead, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.