Individual provider Active NPI

Joel William Nickel, DC

  • Chiropractor
  • Green Bay, WI
National Provider Identifier
1609362938
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5370-12 Issued in WI
Practice address
2420 Finger Rd
Green Bay, WI 54302-4210
Phone
(920) 465-6040
NPI assigned
Jul 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5370-12 WI Primary

Addresses

Primary practice location

2420 Finger Rd
Green Bay, WI 54302-4210

Mailing address

2420 Finger Rd
Green Bay, WI 54302-4210
Phone (920) 465-6040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180912002127 WI Practitioner - Chiropractic 5799035747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Michael W Zoelle SCGroup PAC ID 7810917705, 4 clinicians

Practice addresses (Care Compare)

2420 Finger Rd
Green Bay, WI 54302-4210
Phone (920) 465-6040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5370-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Michael W Zoelle SC Chiropractor CurrentSince Jul 10, 2018 Accepting new patients

Locations

2420 Finger Rd
Green Bay, WI 54302
Phone (920) 465-6040

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1609362938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 FINGER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543024210",
            "telephone_number": "920-465-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 FINGER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543024210",
            "telephone_number": "920-465-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKEL",
        "first_name": "JOEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5370-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 10, 2018; 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.