NPIMap

Organization Active NPI

Wisconsin Spinal Rehabilitation Center S.C.

  • Chiropractor
  • East Troy, WI
National Provider Identifier
1386912954
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3170 Issued in WI
Legal business name
WISCONSIN SPINAL REHABILITATION CENTER S.C.
Practice address
3224 W Main St Ste E
East Troy, WI 53120-1152
Phone
(262) 642-4100
Fax
(262) 642-4101
NPI assigned
Dec 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Authorized official

Name
Peter Gordon Friedrichs, DC
Title
Chiropractor
Phone
(262) 642-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3170 WI Primary

Addresses

Primary practice location

3224 W Main St Ste E
East Troy, WI 53120-1152

Mailing address

3224 W Main St Ste E
PO Box 984
East Troy, WI 53120-1152
Phone (262) 642-4100

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1386912954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 W MAIN ST STE E",
            "address_2": "PO BOX 984",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531201152",
            "telephone_number": "262-642-4100",
            "fax_number": "262-642-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 W MAIN ST STE E",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531201152",
            "telephone_number": "262-642-4100",
            "fax_number": "262-642-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN SPINAL REHABILITATION CENTER S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "FRIEDRICHS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "262-642-4100",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Troy, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.