Organization Active NPI

Michael J Anderson Chiropractic Office Inc

Doing business as Anderson Chiropractic Office

  • Chiropractor
  • Burlington, WI
National Provider Identifier
1649333295
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2399-012 Issued in WI
Legal business name
MICHAEL J ANDERSON CHIROPRACTIC OFFICE INC
Doing business as
Anderson Chiropractic Office
Practice address
733 N Pine St
Burlington, WI 53105-1247
Phone
(262) 763-7373
Fax
(262) 763-8184
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Authorized official

Name
Dr. Michael J Anderson, DCNPI 1578676763
Title
Owner
Phone
(262) 763-7373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2399-012 WI Primary

Addresses

Primary practice location

733 N Pine St
Burlington, WI 53105-1247

Mailing address

733 N Pine St
Burlington, WI 53105-1247
Phone (262) 763-7373

Other identifiers 1

IdentifierTypeStateIssuer
1578676763MedicaidWI

Other names 1

  • Anderson Chiropractic Office Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060223000733 WI Part B Supplier - Clinic/Group Practice 6305852633 Receives reassigned benefits from 2 practitioners
Practice locations: Burlington, WI

National Provider Directory

National Provider Directory

Locations

733 N Pine St
Burlington, WI 53105
Phone (262) 763-7373

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320019200000",
    "number": "1649333295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 N PINE ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051247",
            "telephone_number": "262-763-7373",
            "fax_number": "262-763-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 N PINE ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051247",
            "telephone_number": "262-763-7373",
            "fax_number": "262-763-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J ANDERSON CHIROPRACTIC OFFICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2011-10-31",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-763-7373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2399-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578676763",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Chiropractic Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.