Individual provider Active NPI

Kodi Loren Schroeder, DC

  • Chiropractor
  • Fitchburg, WI
National Provider Identifier
1386120772
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5328 Issued in WI
Practice address
5957 McKee Rd Ste 101
Fitchburg, WI 53719-5150
Phone
(608) 571-3829
NPI assigned
Jul 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5328 WI Primary

Addresses

Primary practice location

5957 McKee Rd Ste 101
Fitchburg, WI 53719-5150

Mailing address

5957 McKee Rd Ste 101
Fitchburg, WI 53719-5150
Phone (608) 571-3829

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180806002276 WI Practitioner - Chiropractic 6103174263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5957 McKee Rd
Suite 101
Fitchburg, WI 53719-5150
Phone (608) 571-3829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5328WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Family Chiropractic LLC Chiropractor CurrentSince Jul 19, 2018 Accepting new patients

Locations

5957 McKee Rd
Ste 101
Fitchburg, WI 53719
Phone (608) 571-3829

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1386120772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5957 MCKEE RD STE 101",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537195150",
            "telephone_number": "608-571-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5957 MCKEE RD STE 101",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537195150",
            "telephone_number": "608-571-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "KODI",
        "middle_name": "LOREN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.