Individual provider Active NPI

Kyle James Friederichs, DC

  • Chiropractor
  • Sheboygan, WI
National Provider Identifier
1689963472
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
474212 Issued in WI
Practice address
620 Michigan Ave
Sheboygan, WI 53081-3042
Phone
(920) 459-8475
NPI assigned
Apr 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 474212 WI Primary

Addresses

Primary practice location

620 Michigan Ave
Sheboygan, WI 53081-3042

Mailing address

1002 Dreifuerst Rd
Plymouth, WI 53073-1422
Phone (920) 627-0901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110517000595 WI Practitioner - Chiropractic 2163608613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Friederichs Chiropractic LLCGroup PAC ID 5193082857, 2 clinicians

Practice addresses (Care Compare)

604 Michigan Ave
Sheboygan, WI 53081-3425
Phone (920) 459-8475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
474212WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Friederichs Chiropractic LLC Chiropractor CurrentSince Sep 1, 2017 Accepting new patients

Locations

604 Michigan Ave
Sheboygan, WI 53081
Phone (920) 457-6330

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1689963472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 DREIFUERST RD",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530731422",
            "telephone_number": "920-627-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MICHIGAN AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813042",
            "telephone_number": "920-459-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDERICHS",
        "first_name": "KYLE",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "474212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.