Individual provider Active NPI

Nichole Rene Schultz, DC

  • Chiropractor
  • Brookfield, WI
National Provider Identifier
1720358153
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4740-12 Issued in WI
Practice address
17280 W North Ave Ste G102
Brookfield, WI 53045-4367
Phone
(262) 789-0576
Fax
(262) 789-5357
NPI assigned
Jan 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4740-12 WI Primary

Addresses

Primary practice location

17280 W North Ave Ste G102
Brookfield, WI 53045-4367

Mailing address

1372N 59TH St
Milwaukee, WI 53208-2140
Phone (309) 335-6618

Other names 1

  • Miss Nichole Rene Yard Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120611000649 WI Practitioner - Chiropractic 1153585732 Practice locations: Brookfield, WI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17280 W N Ave
Brookfield, WI 53045-4367
Phone (262) 789-0576

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4740-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Settimi Chiropractic Center Past Accepting new patients

Organizations & group practices 1

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": "1325462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1720358153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1372N 59TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532082140",
            "telephone_number": "309-335-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17280 W NORTH AVE STE G102",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454367",
            "telephone_number": "262-789-0576",
            "fax_number": "262-789-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "NICHOLE",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-02",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4740-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "YARD",
            "middle_name": "RENE",
            "prefix": "MISS",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.