Individual provider Active NPI

Andrew Patrick Lawrence Neville, D.C.

  • Chiropractor
  • Oak Creek, WI
National Provider Identifier
1710024112
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4068-012 Issued in WI
Practice address
1900 W Ryan Rd
Oak Creek, WI 53154-8233
Phone
(414) 761-5777
Fax
(414) 761-7915
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4068-012 WI Primary

Addresses

Primary practice location

1900 W Ryan Rd
Oak Creek, WI 53154-8233

Mailing address

1900 W Ryan Rd
Oak Creek, WI 53154-8233
Phone (414) 761-5777

Other identifiers 1

IdentifierTypeStateIssuer
38960600MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050407000276 WI Practitioner - Chiropractic 4880641232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Creek Relief and Wellness SCGroup PAC ID 8426014820, 6 clinicians

Practice addresses (Care Compare)

1900 W Ryan Rd
Oak Creek, WI 53154-8233
Phone (414) 761-5777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4068-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Creek Relief and Wellness SC Chiropractor CurrentSince Jul 21, 2022 Accepting new patients
South Shore Family Chiropractic Chiropractor PastSince Dec 28, 2015 Accepting new patients
Potisk Chiropractic Office, S.C. Chiropractor Past Accepting new patients

Locations

1900 W Ryan Rd
Oak Creek, WI 53154
Phone (414) 761-5777

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1710024112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W RYAN RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548233",
            "telephone_number": "414-761-5777",
            "fax_number": "414-761-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W RYAN RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548233",
            "telephone_number": "414-761-5777",
            "fax_number": "414-761-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVILLE",
        "first_name": "ANDREW",
        "middle_name": "PATRICK LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4068-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38960600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.