Individual provider Active NPI

Susan Ann Johnson, D.C.

  • Chiropractor
  • New Richmond, WI
National Provider Identifier
1750457156
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3928-012 Issued in WI
Practice address
446 S. Knowles Ave
New Richmond, WI 54017
Phone
(715) 246-5282
Fax
(715) 246-5569
NPI assigned
Nov 28, 2006
Last updated
Jan 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3928-012 WI Primary
Chiropractor 111N00000X 4140 MN

Addresses

Primary practice location

446 S. Knowles Ave
New Richmond, WI 54017

Mailing address

446 S. Knowles Ave
New Richmond, WI 54017
Phone (715) 246-5282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051220000627 WI Practitioner - Chiropractic 5496777310 Practice locations: New Richmond, WI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

446 N Knowles Ave
New Richmond, WI 54017-1733
Phone (715) 246-5282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3928-012WIMDChiropractor
4140MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Richmond Chiropractic Clinic Inc Chiropractor Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: suejohnson@sccc0004.direct.chirotouch.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1750457156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 S. KNOWLES AVE",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "54017",
            "telephone_number": "715-246-5282",
            "fax_number": "715-246-5569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 S. KNOWLES AVE",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "54017",
            "telephone_number": "715-246-5282",
            "fax_number": "715-246-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3928-012",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4140",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Richmond, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.