Individual provider Active NPI

Eugene R Yellen-Shiring, DC

  • Chiropractor
  • Madison, WI
National Provider Identifier
1649262403
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2874 Issued in WI
Practice address
2702 Monroe St
Madison, WI 53711-1888
Phone
(608) 231-3370
Fax
(608) 231-1547
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2874 WI Primary

Addresses

Primary practice location

2702 Monroe St
Madison, WI 53711-1888

Mailing address

3070 Fish Hatchery Rd
Ste 2
Fitchburg, WI 53713-3187
Phone (608) 231-3370

Other identifiers 1

IdentifierTypeStateIssuer
38865400MedicaidWI

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

LicenseStateTypeSpecialty
2874WIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1649262403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 FISH HATCHERY RD",
            "address_2": "STE 2",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537133187",
            "telephone_number": "608-231-3370",
            "fax_number": "608-231-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111888",
            "telephone_number": "608-231-3370",
            "fax_number": "608-231-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLEN-SHIRING",
        "first_name": "EUGENE",
        "middle_name": "R",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38865400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; 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.