Organization Active NPI

Chiropractic Associates, S.C.

  • Chiropractor
  • West Allis, WI
National Provider Identifier
1730243890
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIROPRACTIC ASSOCIATES, S.C.
Practice address
1467 S 108TH St
West Allis, WI 53214-4018
Phone
(414) 476-6300
Fax
(414) 476-6319
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Charles D Blodgett, DC
Title
Partner Doctor
Phone
(414) 476-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X WI Primary

Addresses

Primary practice location

1467 S 108TH St
West Allis, WI 53214-4018

Mailing address

1467 S 108TH St
West Allis, WI 53214-4018
Phone (414) 476-6300

Other identifiers 1

IdentifierTypeStateIssuer
38995200MedicaidWV

National Provider Directory

National Provider Directory

Locations

1467 S 108th St
West Allis, WI 53214
Phone (414) 476-6300

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730243890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1467 S 108TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144018",
            "telephone_number": "414-476-6300",
            "fax_number": "414-476-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1467 S 108TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144018",
            "telephone_number": "414-476-6300",
            "fax_number": "414-476-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLODGETT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PARTNER DOCTOR",
        "authorized_official_telephone_number": "414-476-6300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38995200",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.