NPIMap

Organization Active NPI

Waukesha Chiropractic & Rehab

  • Chiropractor
  • Waukesha, WI
National Provider Identifier
1386677409
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4001-012 Issued in WI
Legal business name
WAUKESHA CHIROPRACTIC & REHAB
Practice address
628 W Moreland Blvd
Waukesha, WI 53188-2433
Phone
(262) 650-0701
Fax
(262) 522-9858
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Andrew Wayne Treutelaar, D.C.NPI 1821085754
Title
Buissness Owner
Phone
(262) 650-0701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4001-012 WI Primary

Addresses

Primary practice location

628 W Moreland Blvd
Waukesha, WI 53188-2433

Mailing address

628 W Moreland Blvd
Waukesha, WI 53188-2433
Phone (262) 650-0701

Other identifiers 2

IdentifierTypeStateIssuer
38954700MedicaidWI
393686017002OtherWIBCBS PROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

628 W Moreland Blvd
Waukesha, WI 53188
Phone (262) 650-0701

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386677409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882433",
            "telephone_number": "262-650-0701",
            "fax_number": "262-522-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882433",
            "telephone_number": "262-650-0701",
            "fax_number": "262-522-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKESHA CHIROPRACTIC & REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TREUTELAAR",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "BUISSNESS OWNER",
        "authorized_official_telephone_number": "262-650-0701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4001-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38954700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "393686017002",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.