Individual provider Active NPI

Corey James Schneider, D.C.

  • Rehabilitation Chiropractor
  • Glendale, WI
National Provider Identifier
1497833636
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
3825-012 Issued in WI
Practice address
5261 N Port Washington Rd
Suite 101
Glendale, WI 53217-4903
Phone
(414) 332-6001
Fax
(414) 332-3712
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 3825-012 WI Primary
Sports Physician Chiropractor 111NS0005X 3825-012 WI

Addresses

Primary practice location

5261 N Port Washington Rd
Suite 101
Glendale, WI 53217-4903

Mailing address

5261 N Port Washington Rd
Glendale, WI 53217-4903
Phone (414) 332-6001

Other identifiers 1

IdentifierTypeStateIssuer
201717946OtherWITAX ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070216000107 WI Practitioner - Chiropractic 0547362832 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Pain and Joint Care SCGroup PAC ID 3577784446, 3 clinicians

Practice addresses (Care Compare)

5261 N Port Washington Rd
Suite 101
Glendale, WI 53217-4903
Phone (414) 332-6001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3825-012WIMDSports Physician Chiropractor
3825WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Partners, S.C. PastSince Apr 18, 2016 Accepting new patients
Hetz Management, S.C. Past Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1497833636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5261 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174903",
            "telephone_number": "414-332-6001",
            "fax_number": "414-332-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 N PORT WASHINGTON RD",
            "address_2": "SUITE 101",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174903",
            "telephone_number": "414-332-6001",
            "fax_number": "414-332-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "COREY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WI",
            "license": "3825-012",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WI",
            "license": "3825-012",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "201717946",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.