Individual provider Active NPI

John M Reitz, DC

  • Chiropractor
  • Sheboygan, WI
National Provider Identifier
1740331768
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3945-012 Issued in WI
Practice address
1517 S 12TH St
Sheboygan, WI 53081-5243
Phone
(920) 459-8477
Fax
(920) 459-8799
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3945-012 WI Primary

Addresses

Primary practice location

1517 S 12TH St
Sheboygan, WI 53081-5243

Mailing address

1517 S 12TH St
Sheboygan, WI 53081-5243
Phone (920) 459-8477

Other identifiers 1

IdentifierTypeStateIssuer
38946000MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000119 WI Practitioner - Chiropractic 7113027921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1517 S 12TH St
Sheboygan, WI 53081-5243
Phone (920) 459-8477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3945-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Better Life Chiropractic & Wellness SC Chiropractor CurrentSince May 1, 2007 Accepting new patients

Locations

2217 S Memorial Pl
Sheboygan, WI 53081
Phone (920) 208-7000

1517 S 12th St
Sheboygan, WI 53081
Phone (920) 459-8477

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1740331768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 S 12TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530815243",
            "telephone_number": "920-459-8477",
            "fax_number": "920-459-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 S 12TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530815243",
            "telephone_number": "920-459-8477",
            "fax_number": "920-459-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITZ",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3945-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38946000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.