NPIMap

Organization Active NPI

Tiferet Family Chiropractic, S.C.

  • Chiropractor
  • Racine, WI
National Provider Identifier
1659439792
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3954-012 Issued in WI
Legal business name
TIFERET FAMILY CHIROPRACTIC, S.C.
Practice address
5439 Durand Ave Ste 200
Racine, WI 53406-5058
Phone
(262) 554-6869
Fax
(262) 554-6883
NPI assigned
Dec 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stefan Michael Herold, D.C.NPI 1710972724
Title
President
Phone
(262) 554-6869

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 3954-012 WI Primary

Addresses

Primary practice location

5439 Durand Ave Ste 200
Racine, WI 53406-5058

Mailing address

5439 Durand Ave Ste 200
Racine, WI 53406-5058
Phone (262) 554-6869

Other identifiers 1

IdentifierTypeStateIssuer
38999200MedicaidWI

National Provider Directory

National Provider Directory

Locations

5439 Durand Ave
Ste 200
Mount Pleasant, WI 53406
Phone (262) 554-6869

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659439792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5439 DURAND AVE STE 200",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065058",
            "telephone_number": "262-554-6869",
            "fax_number": "262-554-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5439 DURAND AVE STE 200",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065058",
            "telephone_number": "262-554-6869",
            "fax_number": "262-554-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFERET FAMILY CHIROPRACTIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEROLD",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-554-6869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3954-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38999200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.