Individual provider Active NPI

Kelly S Moralez, DC

  • Chiropractor
  • Delavan, WI
National Provider Identifier
1417074998
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3026 Issued in WI
Practice address
1711 Woolsey St.
Suite a
Delavan, WI 53115-2018
Phone
(262) 728-4544
NPI assigned
Mar 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3026 WI Primary

Addresses

Primary practice location

1711 Woolsey St.
Suite a
Delavan, WI 53115-2018

Mailing address

1711 Woolsey St.
Suite a
Delavan, WI 53115-2018

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120331000065 WI Practitioner - Chiropractic 2264608678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Chiropractic Natural Health and Wellness Inc.Group PAC ID 1355517764, 2 clinicians

Practice addresses (Care Compare)

1711 Woolsey St
Suite a
Delavan, WI 53115-2054
Phone (262) 728-4544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Chiropractic Natural Health & Wellness Inc. Chiropractor CurrentSince Jan 1, 1998 Accepting new patients

Locations

1711 Woolsey St
Ste A
Delavan, WI 53115
Phone (262) 728-4544

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417074998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 WOOLSEY ST.",
            "address_2": "SUITE A",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 WOOLSEY ST.",
            "address_2": "SUITE A",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152018",
            "telephone_number": "262-728-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALEZ",
        "first_name": "KELLY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delavan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.