Individual provider Active NPI

Tina M McLeod, D.C.

  • Chiropractor
  • Glendale, WI
National Provider Identifier
1700970266
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4017-012 Issued in WI
Practice address
5306 N Port Washington Rd
Glendale, WI 53217
Phone
(414) 332-0859
Fax
(414) 332-3991
NPI assigned
Oct 2, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 4017-012 WI Primary

Addresses

Primary practice location

5306 N Port Washington Rd
Glendale, WI 53217

Mailing address

5306 N Port Washington Rd
Glendale, WI 53217
Phone (414) 332-0859

Other identifiers 3

IdentifierTypeStateIssuer
7611702OtherWIAETNA
38952600MedicaidWI
391555906018OtherWICOMPCAREBLUE & BLUE CROSS

Other names 1

  • Dr. Tina M Caito Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4017-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Company S.C. Chiropractor Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1700970266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-332-0859",
            "fax_number": "414-332-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-332-0859",
            "fax_number": "414-332-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "TINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4017-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7611702",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38952600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPCAREBLUE & BLUE CROSS",
            "identifier": "391555906018",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "CAITO",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.