Individual provider Active NPI

David Gary Hackbarth, DC

  • Chiropractor
  • Menomonie, WI
National Provider Identifier
1417136201
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2849 Issued in WI
Practice address
3120 Schneider Ave E
Suite #5
Menomonie, WI 54751
Phone
(715) 232-8858
Fax
(715) 232-8868
NPI assigned
Oct 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 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 2849 WI Primary

Addresses

Primary practice location

3120 Schneider Ave E
Suite #5
Menomonie, WI 54751

Mailing address

3120 Schneider Ave E
Suite #5
Menomonie, WI 54751
Phone (715) 232-8858

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101208000133 WI Practitioner - Chiropractic 2163619818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Menomonie Chiropractic Center SCGroup PAC ID 0648469098, 2 clinicians

Practice addresses (Care Compare)

3120 Schneider Ave E
Suite 5
Menomonie, WI 54751-2495

3120 Schneider Ave SE
Suite 5
Menomonie, WI 54751-2495
Phone (715) 232-8858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2849WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Menomonie Chiropractic Center SC Chiropractor CurrentSince May 1, 1997 Accepting new patients

Locations

3120 Schneider Ave SE
Ste 5
Menomonie, WI 54751
Phone (715) 232-8858

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1417136201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 SCHNEIDER AVE E",
            "address_2": "SUITE #5",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "54751",
            "telephone_number": "715-232-8858",
            "fax_number": "715-232-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 SCHNEIDER AVE E",
            "address_2": "SUITE #5",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "54751",
            "telephone_number": "715-232-8858",
            "fax_number": "715-232-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKBARTH",
        "first_name": "DAVID",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.