NPIMap

Organization Active NPI

Advantage Chiropractic Clinic of Green Bay, S.C.

  • Chiropractor
  • Green Bay, WI
National Provider Identifier
1679616148
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ADVANTAGE CHIROPRACTIC CLINIC OF GREEN BAY, S.C.
Practice address
1804 S Ashland Ave
Green Bay, WI 54304-3702
Phone
(920) 432-7774
Fax
(920) 432-7784
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Authorized official

Name
Dr. Cheryl Ann Metzler, D.C., D.A.B.C.I.NPI 1023123403
Title
Owner
Phone
(920) 432-7774

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 MULTIPLE SINGLE SPECIALTY GROUP 111N00000X WI Primary

Addresses

Primary practice location

1804 S Ashland Ave
Green Bay, WI 54304-3702

Mailing address

1804 S Ashland Ave
Green Bay, WI 54304-3702
Phone (920) 432-7774

Other identifiers 2

IdentifierTypeStateIssuer
DD1169OtherWIRAILROAD GROUP NUMBER
3917553140OtherWIBCBS NUMBER

Other names 1

  • Metzler & Raihala Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040616000286 WI Part B Supplier - Clinic/Group Practice 5496739559 Receives reassigned benefits from 1 practitioner
Practice locations: Green Bay, WI

National Provider Directory

National Provider Directory

Locations

1804 S Ashland Ave
Green Bay, WI 54304
Phone (920) 405-9830

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1679616148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 S ASHLAND AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543043702",
            "telephone_number": "920-432-7774",
            "fax_number": "920-432-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 S ASHLAND AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543043702",
            "telephone_number": "920-432-7774",
            "fax_number": "920-432-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE CHIROPRACTIC CLINIC OF GREEN BAY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "METZLER",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-432-7774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., D.A.B.C.I."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP NUMBER",
            "identifier": "DD1169",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "3917553140",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metzler & Raihala Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.