Kimberli Trader, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4622-012 Issued in WI

Practice address

500 Appleton St
Menasha, WI 54952-2330

Phone

(920) 205-0711

NPI assigned

Jul 11, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Yellow Wood Chiropractic

  • Chiropractor
  • Appleton, WI
  • NPI 1194032375
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1278806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278806400000",
    "number": "1720390396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 APPLETON ST",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549522330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 APPLETON ST",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549522330",
            "telephone_number": "920-205-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRADER",
        "first_name": "KIMBERLI",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-11",
        "last_updated": "2010-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4622-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Thompson, LPC-IT
• Kelly Timmers
• Rebecca Timmins
• Richard Raymond Toellner, O.D.
• Carlos Ruben Torres, B.S.
• Stephen Umhoefer
• Kayla Uphill
• Sarah A Vande Hey, NP
• Shauna S Vanden Hoogen, SAC
• Pauline W Vandenberg, LPC

• Chiropractor in Menasha, WI
• Providers in Menasha, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2010; 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.