NPIMap

Organization Active NPI

Chiropractic Spine & Rehab Center, S.C.

  • Chiropractor
  • West Allis, WI
National Provider Identifier
1487000337
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4315-012 Issued in WI
Legal business name
CHIROPRACTIC SPINE & REHAB CENTER, S.C.
Practice address
2349 S 108TH St
West Allis, WI 53227-1927
Phone
(414) 321-1500
Fax
(414) 321-1506
NPI assigned
May 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Authorized official

Name
Dr. Anthony Otto, D.C.
Title
President
Phone
(414) 321-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4315-012 WI Primary

Addresses

Primary practice location

2349 S 108TH St
West Allis, WI 53227-1927

Mailing address

2349 S 108TH St
West Allis, WI 53227-1927
Phone (414) 321-1500

National Provider Directory

National Provider Directory

Locations

2349 S 108th St
West Allis, WI 53227
Phone (414) 321-1500

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1487000337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 S 108TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271927",
            "telephone_number": "414-321-1500",
            "fax_number": "414-321-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 S 108TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271927",
            "telephone_number": "414-321-1500",
            "fax_number": "414-321-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC SPINE & REHAB CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "OTTO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-321-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4315-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.