Black Creek Chiropractic Office LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BLACK CREEK CHIROPRACTIC OFFICE LLC

Practice address

411 S Main St
Black Creek, WI 54106-9501

Phone

(920) 984-3353

Fax

(920) 984-3354

NPI assigned

Jan 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Darrel D Klemp, D.C.NPI 1992885289

Title

Sole Member

Phone

(920) 984-3353

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Darrel D. Klemp, D.C.

  • Chiropractor
  • Black Creek, WI
  • NPI 1992885289
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1730578915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 261",
            "city": "BLACK CREEK",
            "state": "WI",
            "postal_code": "541060261",
            "telephone_number": "920-984-3353",
            "fax_number": "920-984-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S MAIN ST",
            "city": "BLACK CREEK",
            "state": "WI",
            "postal_code": "541069501",
            "telephone_number": "920-984-3353",
            "fax_number": "920-984-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK CREEK CHIROPRACTIC OFFICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "KLEMP",
        "authorized_official_first_name": "DARREL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "920-984-3353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlie James Aschenbach, RN
• Black Creek Dental LLC
• Black Creek Rescue Service
• Traci Rae Bloedorn, ARCB
• Community Eyecare Inc
• Michelle Leanne Draheim, RN

• Chiropractor in Black Creek, WI
• Providers in Black Creek, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.