Individual provider Active NPI

Keith J Oudenhoven, D.C.

  • Chiropractor
  • Appleton, WI
National Provider Identifier
1629013297
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2420-012 Issued in WI
Practice address
3020 E College Ave
Suite F
Appleton, WI 54915-3279
Phone
(920) 738-9996
Fax
(920) 738-0603
NPI assigned
Jun 18, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2420-012 WI Primary

Addresses

Primary practice location

3020 E College Ave
Suite F
Appleton, WI 54915-3279

Mailing address

3020 E College Ave
Suite F
Appleton, WI 54915-3279
Phone (920) 738-9996

Other identifiers 2

IdentifierTypeStateIssuer
P00132309OtherWINETWORK HEALTH PLAN
38894800MedicaidWI

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2420-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Pete Health Associates Chiropractor Past Accepting new patients
Oudenhoven Chiropractic. S.C. Chiropractor Past Accepting new patients

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629013297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 E COLLEGE AVE",
            "address_2": "SUITE F",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549153279",
            "telephone_number": "920-738-9996",
            "fax_number": "920-738-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 E COLLEGE AVE",
            "address_2": "SUITE F",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549153279",
            "telephone_number": "920-738-9996",
            "fax_number": "920-738-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUDENHOVEN",
        "first_name": "KEITH",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2420-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH PLAN",
            "identifier": "P00132309",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38894800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.