Thibodeau Chiropractic, SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2614 Issued in WI

Legal business name

THIBODEAU CHIROPRACTIC, SC

Practice address

1221 E Northland Ave
Appleton, WI 54911-8415

Phone

(920) 954-1002

Fax

(920) 954-1006

NPI assigned

Dec 15, 2007

Last updated

Dec 15, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel John Thibodeau, DCNPI 1730190109

Title

Owner

Phone

(920) 954-1002

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel John Thibodeau, D.C.

  • Chiropractor
  • Appleton, WI
  • NPI 1730190109
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1197676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197676800000",
    "number": "1528241353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E NORTHLAND AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118415",
            "telephone_number": "920-954-1002",
            "fax_number": "920-954-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E NORTHLAND AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118415",
            "telephone_number": "920-954-1002",
            "fax_number": "920-954-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIBODEAU CHIROPRACTIC, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-15",
        "last_updated": "2007-12-15",
        "status": "A",
        "authorized_official_last_name": "THIBODEAU",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-954-1002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph E Theisen, PT, ATC
• Therapy Time for K.I.D.S.
• Adrian Chaya Theriot, MD
• Jessica Marie Theroux, ATC, CSCS
• Kami Thews
• Daniel John Thibodeau, D.C.
• Kelly Thiel, NP-C
• Maggie S Thiel, OT
• Stefanie Thiel
• Lisa R Thiltgen, APRN

• Chiropractor in Appleton, WI
• Providers in Appleton, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.