Highland Chiropractic SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3880-012 Issued in WI

Legal business name

HIGHLAND CHIROPRACTIC SC

Practice address

1501 E Sumner St
Hartford, WI 53027-2608

Phone

(262) 673-7600

Fax

(262) 673-7692

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Dustin David Riddle, DC

Title

Doctor

Phone

(262) 673-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Community Chiropractic center Doing business as

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487856019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E SUMNER ST",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530272608",
            "telephone_number": "262-673-7600",
            "fax_number": "262-673-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E SUMNER ST",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530272608",
            "telephone_number": "262-673-7600",
            "fax_number": "262-673-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND CHIROPRACTIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "262-673-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3880-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38961800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Chiropractic center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marianna M Herrera, CRNA
• Herslof'S, Inc
• Aleese Hetzel
• Bruce Edward Hickman, MD
• Mackenzie Ann Hicks, CCC-SLP
• Amber Hildebrandt, M.D.
• Jonathan Hill
• Enisa Hodzic, M.D.
• Amy Jo Hoeppner, RN
• Tracy Ellen Hoffman, MS, OTR/L

• All providers in Hartford, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.