Individual provider Active NPI

William I Melby, D.C.

  • Chiropractor
  • Union Grove, WI
National Provider Identifier
1467558445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2071-012 Issued in WI
Practice address
1208 Main St
Union Grove, WI 53182-1304
Phone
(262) 878-4109
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

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 2071-012 WI Primary

Addresses

Primary practice location

1208 Main St
Union Grove, WI 53182-1304

Mailing address

1208 Main St
Union Grove, WI 53182-1304
Phone (262) 878-4109

Other identifiers 1

IdentifierTypeStateIssuer
38794800MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080609000447 WI Practitioner - Chiropractic 9537062005 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2071-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Melby Chiropractic Clinic, S.C. Chiropractor CurrentSince Jan 30, 2004 Accepting new patients

Locations

1208 Main St
Union Grove, WI 53182
Phone (262) 878-4109

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467558445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 MAIN ST",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821304",
            "telephone_number": "262-878-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 MAIN ST",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821304",
            "telephone_number": "262-878-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELBY",
        "first_name": "WILLIAM",
        "middle_name": "I",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2071-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38794800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union Grove, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.