Individual provider Active NPI

David C. Reif, D.C.

  • Chiropractor
  • Port Washington, WI
National Provider Identifier
1548372576
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3605-012 Issued in WI
Practice address
1000 N Wisconsin St
Port Washington, WI 53074-1285
Phone
(262) 284-7246
NPI assigned
Aug 31, 2006
Last updated
Mar 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3605-012 WI Primary

Addresses

Primary practice location

1000 N Wisconsin St
Port Washington, WI 53074-1285

Mailing address

1329 W Grand Ave
Ste 4
Port Washington, WI 53074-2010
Phone (262) 284-7246

Other identifiers 1

IdentifierTypeStateIssuer
38923600MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050114000431 WI Practitioner - Chiropractic 9032168273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1329 W Grand Ave
Suite 4
Port Washington, WI 53074-2010
Phone (262) 284-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3605-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Port Chiropractic Inc. Chiropractor CurrentSince Sep 15, 2007 Accepting new patients
Align Chiropractic of Port, S.C. Chiropractor Past Accepting new patients

Locations

1000 N Wisconsin St
Port Washington, WI 53074
Phone (262) 284-7246

1329 W Grand Ave
Ste 4
Port Washington, WI 53074
Phone (262) 284-7246

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1548372576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 W GRAND AVE",
            "address_2": "STE 4",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530742010",
            "telephone_number": "262-284-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WISCONSIN ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741285",
            "telephone_number": "262-284-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIF",
        "first_name": "DAVID",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3605-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38923600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.