Organization Active NPI

Webley Chiropractic Clinic, S.C.

  • Chiropractor
  • Burlington, WI
National Provider Identifier
1710040365
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3283-012 Issued in WI
Legal business name
WEBLEY CHIROPRACTIC CLINIC, S.C.
Practice address
1050 Milwaukee Ave
Suite 101
Burlington, WI 53105-1362
Phone
(262) 763-6000
Fax
(262) 763-1886
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Authorized official

Name
Dr. James D Webley Jr., DCNPI 1154435345
Title
Owner
Phone
(262) 763-6000

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 SINGLE SPECIALTY GROUP 111N00000X 3283-012 WI Primary

Addresses

Primary practice location

1050 Milwaukee Ave
Suite 101
Burlington, WI 53105-1362

Mailing address

1050 Milwaukee Ave Ste 101
P.O. Box 698
Burlington, WI 53105-1362
Phone (262) 763-6000

Other identifiers 2

IdentifierTypeStateIssuer
38897100MedicaidWI
000035912OtherWIMEDICARE GROUP UNSPECIFIED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070125000099 WI Part B Supplier - Clinic/Group Practice 0648271270 Receives reassigned benefits from 1 practitioner
Practice locations: Burlington, WI

National Provider Directory

National Provider Directory

Locations

733 N Pine St
Ste B
Burlington, WI 53105
Phone (262) 763-7583

Practitioners & affiliated clinicians

Practitioners 1

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": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1710040365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 MILWAUKEE AVE STE 101",
            "address_2": "P.O. BOX 698",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051362",
            "telephone_number": "262-763-6000",
            "fax_number": "262-763-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 MILWAUKEE AVE",
            "address_2": "SUITE 101",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051362",
            "telephone_number": "262-763-6000",
            "fax_number": "262-763-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBLEY CHIROPRACTIC CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "WEBLEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-763-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3283-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38897100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP UNSPECIFIED",
            "identifier": "000035912",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.