Organization Active NPI

Schneider Chiropratic Office SC

  • Chiropractor
  • Green Bay, WI
National Provider Identifier
1598065849
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2662 Issued in WI
Legal business name
SCHNEIDER CHIROPRATIC OFFICE SC
Practice address
2696 Noel Dr
Green Bay, WI 54311-6729
Phone
(920) 465-9020
Fax
(920) 465-9020
NPI assigned
Nov 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

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

Authorized official

Name
Jill S Wilson
Title
Office Manager
Phone
(920) 465-9020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2662 WI Primary

Addresses

Primary practice location

2696 Noel Dr
Green Bay, WI 54311-6729

Mailing address

2696 Noel Dr
Green Bay, WI 54311-6729
Phone (920) 465-9020

Other identifiers 2

IdentifierTypeStateIssuer
350052795OtherWIRAILROAD MEDICARE
3885160MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101206000568 WI Part B Supplier - Clinic/Group Practice 0840487617 Receives reassigned benefits from 2 practitioners
Practice locations: Green Bay, WI

National Provider Directory

National Provider Directory

Locations

2696 Noel Dr
Green Bay, WI 54311
Phone (920) 465-9020

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1598065849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2696 NOEL DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116729",
            "telephone_number": "920-465-9020",
            "fax_number": "920-465-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2696 NOEL DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116729",
            "telephone_number": "920-465-9020",
            "fax_number": "920-465-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHNEIDER CHIROPRATIC OFFICE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-465-9020"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350052795",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3885160",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

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