NPIMap

Organization Active NPI

Kluewer Chiropractic, Inc

  • Chiropractor
  • Beaver Dam, WI
National Provider Identifier
1467832899
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4936-12 Issued in WI
Legal business name
KLUEWER CHIROPRACTIC, INC
Doing business as
Kluewer Chiropractic
Practice address
1229 N Center St
Beaver Dam, WI 53916-1147
Phone
(920) 219-9322
Fax
(920) 219-9323
NPI assigned
Jun 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Authorized official

Name
Dr. Jordan Mark Kluewer, D.C.NPI 1003257254
Title
Doctor of Chiropractic
Phone
(920) 253-7374

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)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4936-12 WI Primary

Addresses

Primary practice location

1229 N Center St
Beaver Dam, WI 53916-1147

Mailing address

1229 N Center St
Beaver Dam, WI 53916-1147
Phone (920) 219-9322

Other names 1

  • Kluewer Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151207000373 WI Part B Supplier - Clinic/Group Practice 3870893357 Receives reassigned benefits from 1 practitioner
Practice locations: Beaver Dam, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1467832899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 N CENTER ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161147",
            "telephone_number": "920-219-9322",
            "fax_number": "920-219-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 N CENTER ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161147",
            "telephone_number": "920-219-9322",
            "fax_number": "920-219-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLUEWER CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "KLUEWER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "920-253-7374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4936-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kluewer Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.