Shae A Doran, D.C., CACCP

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4205-012 Issued in WI

Practice address

5583 W Waterford LN
Ste B
Appleton, WI 54913

Phone

(920) 419-1457

Fax

(920) 243-0241

NPI assigned

Apr 4, 2008

Last updated

Feb 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Breath of Life Chiropractic Wellness Center

  dba Breath of Life Chiropractic

  • Clinic/Center
  • Appleton, WI
  • NPI 1508159088
  Authorized official Same address or phone

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1639342173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5583 W WATERFORD LN",
            "address_2": "STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-419-1457",
            "fax_number": "920-243-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5583 W WATERFORD LN",
            "address_2": "STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-419-1457",
            "fax_number": "920-243-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAN",
        "first_name": "SHAE",
        "middle_name": "A",
        "credential": "D.C., CACCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4205-012",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "WI",
            "license": "4205-012",
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "WI",
            "license": "4205-12",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donnermeyer Chiropractic L.L. C.
• Bradley P Donnermeyer, DC
• Jane E. Doolan, MS, LPC
• Morgan R Dopp, DPT
• Sara N Doran, CCC-SLP
• Marialyce Brennan Dorman, LMT
• Kristin A Dorn, LCSW
• Brianna L Dostalek, PA
• Wendi A Doszak, COTA
• Sarah M Dotterweich, PTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.