NPIMap

Organization Active NPI

Poland Chiropractic Inc

Doing business as Poland Chiropractic

  • Chiropractor
  • Wausau, WI
National Provider Identifier
1376913582
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1404-012 Issued in WI
Legal business name
POLAND CHIROPRACTIC INC
Doing business as
Poland Chiropractic
Practice address
228 N 3Rd Ave
Wausau, WI 54401-4410
Phone
(715) 845-6722
NPI assigned
Sep 30, 2015
Last updated
Sep 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Authorized official

Name
H Dale H Poland, DC
Title
Owner
Phone
(715) 845-6722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1404-012 WI Primary

Addresses

Primary practice location

228 N 3Rd Ave
Wausau, WI 54401-4410

Mailing address

228 N 3Rd Ave
Wausau, WI 54401-4410
Phone (715) 845-6722

Other names 1

  • Poland Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151113000700 WI Part B Supplier - Clinic/Group Practice 9537479043 Receives reassigned benefits from 3 practitioners
Practice locations: Wausau, WI

National Provider Directory

National Provider Directory

Locations

228 N 3rd Ave
Wausau, WI 54401
Phone (715) 845-5722

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1376913582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 N 3RD AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014410",
            "telephone_number": "715-845-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 N 3RD AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014410",
            "telephone_number": "715-845-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLAND CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "POLAND",
        "authorized_official_first_name": "H DALE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-845-6722",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1404-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poland Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.