William Charles Groskopp, D.C.
Individual provider Active NPI Chiropractor · Brillion, WI
NPI 1497767909 · NPPES record last updated Aug 23, 2011
Key facts
- NPI
- 1497767909
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1608-012 (WI)
- Practice address
- 205 N Main St
Suite 3
Brillion, WI 54110-1197 - Phone
- (920) 756-2151
- Fax
- (920) 756-2152
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1608-012 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1608-012 | WI | Yes |
Addresses
Primary practice location
205 N Main St
Suite 3
Brillion, WI 54110-1197
Mailing address
205 N Main St
Suite 3
Brillion, WI 54110-1197
Phone (920) 756-2151
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E-30001791 | Medicaid | WI |
Other providers in Brillion, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.