NPIMap

Organization Active NPI

Belleville Chiropractic and Wellness Center, S.C.

  • Chiropractor
  • Belleville, WI
National Provider Identifier
1649473380
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3786-012 Issued in WI
Legal business name
BELLEVILLE CHIROPRACTIC AND WELLNESS CENTER, S.C.
Practice address
1019 River St
Suite 5
Belleville, WI 53508-9181
Phone
(605) 424-1840
NPI assigned
Jun 8, 2007
Last updated
Nov 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Authorized official

Name
Dr. Brad K. Freitag, DCNPI 1902833957
Title
President
Phone
(608) 424-1840

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
Chiropractor 111N00000X 3786-012 WI Primary

Addresses

Primary practice location

1019 River St
Suite 5
Belleville, WI 53508-9181

Mailing address

1019 River St
Suite 5
Belleville, WI 53508-9181
Phone (605) 424-1840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070816000260 WI Part B Supplier - Clinic/Group Practice 1658463955 Receives reassigned benefits from 2 practitioners
Practice locations: Belleville, WI

National Provider Directory

National Provider Directory

Locations

1019 River St
Ste 5
Belleville, WI 53508
Phone (605) 424-1840

1100 Bellwest Blvd
Belleville, WI 53508
Phone (608) 424-1840

Practitioners & affiliated clinicians

Practitioners 3

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": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1649473380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 RIVER ST",
            "address_2": "SUITE 5",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089181",
            "telephone_number": "605-424-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 RIVER ST",
            "address_2": "SUITE 5",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089181",
            "telephone_number": "605-424-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVILLE CHIROPRACTIC AND WELLNESS CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "FREITAG",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-424-1840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3786-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.