Daniel John Thibodeau, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2614 Issued in WI

Practice address

1221 E Northland Ave
Appleton, WI 54911-8415

Phone

(920) 954-1002

Fax

(920) 954-1006

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thibodeau Chiropractic, SC

  • Chiropractor
  • Appleton, WI
  • NPI 1528241353
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730190109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E NORTHLAND AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118415",
            "telephone_number": "920-954-1002",
            "fax_number": "920-954-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E NORTHLAND AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118415",
            "telephone_number": "920-954-1002",
            "fax_number": "920-954-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38848700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therapy Time for K.I.D.S.
• Adrian Chaya Theriot, MD
• Jessica Marie Theroux, ATC, CSCS
• Kami Thews
• Thibodeau Chiropractic, SC
• Kelly Thiel, NP-C
• Maggie S Thiel, OT
• Stefanie Thiel
• Lisa R Thiltgen, APRN
• Kelly Thomack

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.