Organization Active NPI

Dragt Chiropractic LLC

  • Chiropractor
  • Marshfield, WI
National Provider Identifier
1710314604
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2914 Issued in WI
Legal business name
DRAGT CHIROPRACTIC LLC
Practice address
202 E Upham St
Marshfield, WI 54449-1543
Phone
(715) 384-9050
Fax
(715) 384-6509
NPI assigned
Oct 9, 2013
Last updated
Oct 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2013

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

Authorized official

Name
Randall L Dragt, D.C.NPI 1578669883
Title
Owner
Phone
(715) 384-9050

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 2914 WI Primary

Addresses

Primary practice location

202 E Upham St
Marshfield, WI 54449-1543

Mailing address

202 E Upham St
Marshfield, WI 54449-1543
Phone (715) 384-9050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140116001501 WI Part B Supplier - Clinic/Group Practice 8123256278 Receives reassigned benefits from 2 practitioners
Practice locations: Marshfield, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2071087Dragt Chiropractic, LLC202 East Upham Street, Marshfield, WI 54449Certificate of waiverJan 1, 2028

National Provider Directory

National Provider Directory

Locations

202 E Upham St
Marshfield, WI 54449
Phone (608) 756-5225

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381968000000",
    "number": "1710314604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E UPHAM ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491543",
            "telephone_number": "715-384-9050",
            "fax_number": "715-384-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E UPHAM ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491543",
            "telephone_number": "715-384-9050",
            "fax_number": "715-384-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAGT CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-17",
        "status": "A",
        "authorized_official_last_name": "DRAGT",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-384-9050",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.