Individual provider Active NPI

Gerald Harvey Retzlaff, DC

  • Chiropractor
  • Eau Claire, WI
National Provider Identifier
1528069317
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1370-012 Issued in WI
Practice address
2627 N Clairemont Ave
Eau Claire, WI 54703-2405
Phone
(715) 552-3232
Fax
(715) 552-3233
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1370-012 WI Primary

Addresses

Primary practice location

2627 N Clairemont Ave
Eau Claire, WI 54703-2405

Mailing address

2627 N Clairemont Ave
Eau Claire, WI 54703-2405
Phone (715) 552-3232

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080627000159 WI Practitioner - Chiropractic 7911079496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paulsrud Chiropractic LLCGroup PAC ID 2567474588, 6 clinicians

Practice addresses (Care Compare)

2627 N Clairemont Ave
Eau Claire, WI 54703-2405
Phone (715) 552-3232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1370-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Paulsrud Chiropractic LLC Chiropractor CurrentSince Feb 1, 2016 Accepting new patients
Michael J Court, Inc Chiropractor PastSince Sep 27, 2015 Accepting new patients

Locations

2627 N Clairemont Ave
Eau Claire, WI 54703
Phone (715) 552-3232

Organizations & group practices 2

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": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1528069317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 N CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547032405",
            "telephone_number": "715-552-3232",
            "fax_number": "715-552-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 N CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547032405",
            "telephone_number": "715-552-3232",
            "fax_number": "715-552-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETZLAFF",
        "first_name": "GERALD",
        "middle_name": "HARVEY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1370-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.