Individual provider Active NPI

George William Berres, D.C.,C.C.S.P.

  • Sports Physician Chiropractor
  • Colfax, WI
National Provider Identifier
1720046428
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
2087 Issued in WI
Practice address
617 Main St
Colfax, WI 54730-9148
Phone
(715) 962-3225
Fax
(715) 962-3225
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 2087 WI Primary

Addresses

Primary practice location

617 Main St
Colfax, WI 54730-9148

Mailing address

PO Box 265
617 Main Street
Colfax, WI 54730-0265
Phone (715) 962-3225

Other identifiers 1

IdentifierTypeStateIssuer
38793900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060215000569 WI Practitioner - ChiropracticPractitioner - Sports Medicine 1951316744 Practice locations: Colfax, WI

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Sports Medicine
Education
Palmer College Chiropractic - Davenport, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

617 Main St
Colfax, WI 54730-9148
Phone (715) 962-3225

PO Box
Suite 265
Colfax, WI 54730-0265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2087WIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720046428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "address_2": "617 MAIN STREET",
            "city": "COLFAX",
            "state": "WI",
            "postal_code": "547300265",
            "telephone_number": "715-962-3225",
            "fax_number": "715-962-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 MAIN ST",
            "city": "COLFAX",
            "state": "WI",
            "postal_code": "547309148",
            "telephone_number": "715-962-3225",
            "fax_number": "715-962-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRES",
        "first_name": "GEORGE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.,C.C.S.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WI",
            "license": "2087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38793900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colfax, WI

Sources for this page

Verify at the official NPI Registry.