Clark D Heller, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4069-012 Issued in WI

Practice address

1221 Phoenix St
Delavan, WI 53115-2340

Phone

(262) 728-8208

Fax

(262) 728-9818

NPI assigned

Apr 9, 2007

Last updated

Dec 7, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Walworth County Chiropractic

  • Chiropractor
  • Delavan, WI
  • NPI 1548598352
  Medicare reassignment NPD
• Dr Howard R Henning SC

  • Chiropractor
  • Delavan, WI
  • NPI 1780810952
  NPD (past)
• Great Basin Spine and Sports

  • Chiropractor
  • Washington Terrace, UT
  • NPI 1639485014
  NPD (past)
• Ogden Family Chiropractic LLC

  • Primary Care Clinic/Center
  • Washington Terrace, UT
  • NPI 1427293695
  NPD (past)
• Patient First Chiropractic

  • Chiropractor
  • Lexington, KY
  • NPI 1205946324
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1669595054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PHOENIX ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152340",
            "telephone_number": "262-728-8208",
            "fax_number": "262-728-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PHOENIX ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152340",
            "telephone_number": "262-728-8208",
            "fax_number": "262-728-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "CLARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4069-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "000535686",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Tara Joy Gronau, MD
• Patricia Conlon Grosso, OTR/L
• Richard Hall, R.PH.
• Bruce Ray Hammer
• Christine Hartwig, DVM
• Howard R Henning, DC
• Ronald Wayne Henson, O.D.
• Olivia Hernandez, PT
• Mikaela Lee Hilker, PT
• Arleen Katherine Hill, OTR

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.