Individual provider Active NPI

Susan E. Rupp, DC

  • Chiropractor
  • Columbus, WI
National Provider Identifier
1700893567
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3512-012 Issued in WI
Practice address
146 W Mill St
Columbus, WI 53925-1585
Phone
(920) 623-1106
Fax
(920) 623-1107
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3512-012 WI Primary

Addresses

Primary practice location

146 W Mill St
Columbus, WI 53925-1585

Mailing address

146 W. Mill Street
Columbus, WI 53925
Phone (920) 623-1106

Other identifiers 1

IdentifierTypeStateIssuer
39000400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041021000761 WI Practitioner - Chiropractic 4385605435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1349 Park Ave
Columbus, WI 53925-1614
Phone (920) 623-1106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3512-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Zelm Chiropractic Center SC Chiropractor CurrentSince Feb 12, 2007 Accepting new patients
Quick Fix After Hours Chiropractic Care, LLC Past Accepting new patients

Locations

4861 Larson Beach Rd
McFarland, WI 53558
Phone (608) 838-7723

Organizations & group practices 3

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700893567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 W. MILL STREET",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "53925",
            "telephone_number": "920-623-1106",
            "fax_number": "920-623-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 W MILL ST",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251585",
            "telephone_number": "920-623-1106",
            "fax_number": "920-623-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPP",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3512-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39000400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.