Active NPI
Krieser Family Chiropractic, LLC
- Chiropractor
- Nashotah, WI
National Provider Identifier
1417092909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4167-012
- Legal business name
- KRIESER FAMILY CHIROPRACTIC, LLC
- Practice address
- W330N4339 Lakeland Dr
Nashotah, WI 53058-9798 - Phone
- (262) 563-1000
- Fax
- (262) 563-1200
- NPI assigned
- Feb 21, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kenneth J Krieser, DC
- Title
- Owner
- Phone
- (262) 563-1000
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4167-012 | WI | Primary |
Addresses
Primary practice location
W330N4339 Lakeland Dr
Nashotah, WI 53058-9798
Mailing address
W330N4339 Lakeland Dr
Nashotah, WI 53058-9798
Phone (262) 563-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38967400 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1280 Brown St
Ste F
Oconomowoc, WI 53066
Phone (262) 567-6700
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Nashotah, WI
- NPI 1013973155
-
- Massage Therapist
- Nashotah, WI
- NPI 1366219578
-
- Chiropractor
- Nashotah, WI
- NPI 1710809959
-
- Health Service Clinic/Center
- Nashotah, WI
- NPI 1013325505
-
- Massage Therapist
- Oconomowoc, WI
- NPI 1609122399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1379548800000",
"number": "1417092909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W330N4339 LAKELAND DR",
"city": "NASHOTAH",
"state": "WI",
"postal_code": "530589798",
"telephone_number": "262-563-1000",
"fax_number": "262-563-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W330N4339 LAKELAND DR",
"city": "NASHOTAH",
"state": "WI",
"postal_code": "530589798",
"telephone_number": "262-563-1000",
"fax_number": "262-563-1200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KRIESER FAMILY CHIROPRACTIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-21",
"last_updated": "2013-09-19",
"status": "A",
"authorized_official_last_name": "KRIESER",
"authorized_official_first_name": "KENNETH",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "262-563-1000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "WI",
"license": "4167-012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38967400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Nashotah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.