Active NPI
Chad Alan Cloutier, DC
- Chiropractor
- Waupaca, WI
National Provider Identifier
1710079413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4155-012
- Practice address
- 830 School St
Waupaca, WI 54981-1633 - Phone
- (715) 258-2800
- Fax
- (715) 258-2885
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4155-012 | WI | Primary |
Addresses
Primary practice location
830 School St
Waupaca, WI 54981-1633
Mailing address
830 School St
Waupaca, WI 54981-1633
Phone (715) 258-2800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
830 School St
Waupaca, WI 54981-1633
Phone (715) 258-2800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4155-012 | WI | MD | Chiropractor |
| 4155 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Chiropractors Inc | Chiropractor | Past | Accepting new patients |
| Sell Chiropractic | Chiropractor | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418083200000",
"number": "1710079413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 SCHOOL ST",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549811633",
"telephone_number": "715-258-2800",
"fax_number": "715-258-2885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 SCHOOL ST",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549811633",
"telephone_number": "715-258-2800",
"fax_number": "715-258-2885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOUTIER",
"first_name": "CHAD",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2014-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "4155-012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waupaca, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.