Chiropractic Health & Rehabilitation Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4025 012 Issued in WI

Legal business name

CHIROPRACTIC HEALTH & REHABILITATION CENTER

Practice address

N1724 Municipal Dr
Greenville, WI 54942-8721

Phone

(920) 757-5771

Fax

(920) 757-0373

NPI assigned

May 10, 2007

Last updated

Mar 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Clint Ryan Dorn, D.C.NPI 1053476168

Title

Chiropractor Owner

Phone

(920) 757-5771

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Tax ID family

Chiropractic Health Rehabilitation Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Chiropractic Health of Appleton, LLC

  • Chiropractor
  • Appleton, WI
  • NPI 1386297760
  NPD tax ID
• Chiropractic Health of Neenah, LLC

  • Chiropractor
  • Neenah, WI
  • NPI 1881395051
  NPD tax ID
• Chiropractic Health of Oshkosh, LLC

  • Chiropractor
  • Oshkosh, WI
  • NPI 1306472618
  NPD tax ID

Locations

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Chiropractic Health of Appleton, LLC

  • Chiropractor
  • Appleton, WI
  • NPI 1386297760
  NPPES parent name
• Chiropractic Health of Neenah, LLC

  • Chiropractor
  • Neenah, WI
  • NPI 1881395051
  NPPES parent name
• Chiropractic Health of Oshkosh, LLC

  • Chiropractor
  • Oshkosh, WI
  • NPI 1306472618
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clint Ryan Dorn, DC

  • Chiropractor
  • Greenville, WI
  • NPI 1053476168
  Medicare reassignment Care Compare group NPD Authorized official
• Marina Eggen, DC

  • Chiropractor
  • Greenville, WI
  • NPI 1033745955
  Medicare reassignment Care Compare group NPD
• Grant Larie, D.C.

  • Chiropractor
  • De Pere, WI
  • NPI 1770939159
  Medicare reassignment Care Compare group NPD
• Steven James Fisher, D.C.

  • Chiropractor
  • Two Rivers, WI
  • NPI 1538488663
  Medicare reassignment

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1467667972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N1724 MUNICIPAL DR",
            "city": "GREENVILLE",
            "state": "WI",
            "postal_code": "549428721",
            "telephone_number": "920-757-5771",
            "fax_number": "920-757-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N1724 MUNICIPAL DR",
            "city": "GREENVILLE",
            "state": "WI",
            "postal_code": "549428721",
            "telephone_number": "920-757-5771",
            "fax_number": "920-757-0373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1765 Taft Ave",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549023220",
            "country_code": "US",
            "telephone_number": "920-233-7744",
            "fax_number": "920-233-7891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "835 Main St",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549562254",
            "country_code": "US",
            "telephone_number": "920-727-1234",
            "fax_number": "920-727-1458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 E College Ave Ste H",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549153253",
            "country_code": "US",
            "telephone_number": "920-738-9997",
            "fax_number": "920-738-0603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHIROPRACTIC HEALTH & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "DORN",
        "authorized_official_first_name": "CLINT",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "CHIROPRACTOR OWNER",
        "authorized_official_telephone_number": "920-757-5771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4025 012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38956200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelina Bartel, LPC
• Paige Berlin
• Ann Cecelia Braaten, RPH
• Cindy Caroline Brylski-Breit, RN, BSN, IBCLC
• Jamie Budzynski
• Janet Creapo, LMT
• Gabriel Dewar, DC
• Patrick Shannon Dewar, DC
• Clint Ryan Dorn, DC
• Julia Dudenas

• Chiropractor in Greenville, WI
• Providers in Greenville, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.