Isaiah J Griesbach, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5693-12 Issued in WI

Practice address

1624 E Mason St
Green Bay, WI 54302-2739

Phone

(920) 465-0400

Fax

(920) 465-1430

NPI assigned

Nov 22, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• East Side Chiropractic and Laser Therapy Center LLC

  dba East Side Chiropractic

  • Chiropractor
  • Green Bay, WI
  • NPI 1508506353
  Medicare reassignment NPD

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1447917703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MAPLE DR",
            "city": "BONDUEL",
            "state": "WI",
            "postal_code": "541079243",
            "telephone_number": "715-851-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 E MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543022739",
            "telephone_number": "920-465-0400",
            "fax_number": "920-465-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIESBACH",
        "first_name": "ISAIAH",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5693-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Gresham
• Gregory M Grewe, MD
• Amber Mae Griep, BSN
• Scott M Griep, MS, PA, ATC
• Sarah Marie Gries-Thomas, APNP
• Paige E Griesbach, RN
• Wayne Griesbach, MA
• Robert C Griesser, MD
• Trudi A Griffin, LPC
• Tina M Griffith

• Chiropractor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.

Verify at the official NPI Registry.