John B. Dietrich II, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3621-012 Issued in WI

Practice address

1105 W Grand Ave
Wisconsin Rapids, WI 54495-3349

Phone

(715) 423-4050

Fax

(715) 424-3108

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Dietrich Chiropractic, SC

  • Chiropractor
  • Wisconsin Rapids, WI
  • NPI 1568641116
  Medicare reassignment NPD
• Stoiber Healthcare S.C.

  • Chiropractor
  • Wisconsin Rapids, WI
  • NPI 1376605246
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477607307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 W GRAND AVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544953349",
            "telephone_number": "715-423-4050",
            "fax_number": "715-424-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W GRAND AVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544953349",
            "telephone_number": "715-423-4050",
            "fax_number": "715-424-3108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "JOHN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3621-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38922000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Derringer
• Makena Lizabeth Detlor, LPC-IT
• Tina Diaz
• Scott E Dickman, MD
• Dietrich Chiropractic, SC
• Marissa Nicole Dobratz, RN
• Mary Elizabeth Doolittle, DDS
• Rebecca Dorshorst, CFA
• Michael J Downs, OD
• Dr. Victoria Zueger, S.C.

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

• 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.
• 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.