Walworth County Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3043-012 Issued in WI

Legal business name

WALWORTH COUNTY CHIROPRACTIC

Practice address

1221 Phoenix St
Delavan, WI 53115-2340

Phone

(262) 728-8208

Fax

(262) 728-9818

NPI assigned

Dec 7, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Fred D Heller, D.C.NPI 1164520623

Title

President

Phone

(920) 604-1886

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clark D Heller, D.C.

  • Chiropractor
  • Delavan, WI
  • NPI 1669595054
  Medicare reassignment NPD
• Fred Dana Heller, D.C.

  • Chiropractor
  • Oconto Falls, WI
  • NPI 1164520623
  NPD (past) Authorized official

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1548598352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 CALDWELL AVE",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541139",
            "telephone_number": "920-846-3778",
            "fax_number": "920-846-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PHOENIX ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152340",
            "telephone_number": "262-728-8208",
            "fax_number": "262-728-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALWORTH COUNTY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-604-1886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3043-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuel L Vivero, MD
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• James Winchester Wallace, O.D.
• Lisa A Wang, APRN, FNP
• Jesse A Warner, LAC, MSOM
• Kristine L. Warrenburg, RN
• Christine Lynn Weerts, NP
• Emily Williams

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.