Active NPI
Jeffrey Fruendt, D.C.
- Chiropractor
- Watertown, WI
National Provider Identifier
1598840753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- WI3037
- Practice address
- 615 E Main St
Suite B
Watertown, WI 53094-3200 - Phone
- (920) 261-2204
- Fax
- (920) 261-3901
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | WI3037 | WI | Primary |
Addresses
Primary practice location
615 E Main St
Suite B
Watertown, WI 53094-3200
Mailing address
615 E Main St
Suite B
Watertown, WI 53094-3200
Phone (920) 261-2204
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38992600 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WI3037 | WI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475539200000",
"number": "1598840753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 E MAIN ST",
"address_2": "SUITE B",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530943200",
"telephone_number": "920-261-2204",
"fax_number": "920-261-3901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 E MAIN ST",
"address_2": "SUITE B",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530943200",
"telephone_number": "920-261-2204",
"fax_number": "920-261-3901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRUENDT",
"first_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2016-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "WI3037",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38992600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.