Dorn Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3622-012 Issued in WI

Legal business name

DORN CHIROPRACTIC, LLC

Practice address

888 Thackeray TRL
Suite 210
Oconomowoc, WI 53066-4342

Phone

(262) 560-9600

Fax

(262) 560-9599

NPI assigned

Sep 13, 2007

Last updated

Apr 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brady Dorn, DCNPI 1124170675

Title

Owner of Dorn Chiropractic, LLC.

Phone

(262) 560-9600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brady Robert Dorn, DC

  • Chiropractor
  • Oconomowoc, WI
  • NPI 1124170675
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1750576542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL",
            "address_2": "SUITE 210",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-560-9600",
            "fax_number": "262-560-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL",
            "address_2": "SUITE 210",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-560-9600",
            "fax_number": "262-560-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DORN CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "DORN",
        "authorized_official_first_name": "BRADY",
        "authorized_official_title_or_position": "OWNER OF DORN CHIROPRACTIC, LLC.",
        "authorized_official_telephone_number": "262-560-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3622-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Deal
• Lisa Deal, CADC III, CCS II
• Bonita Jean Debban, PH.D
• Pete Dickman, PHARMACIST
• Amanda Donath, LPC
• Dorn Family Chiropractic LLC (Axis Chiropractic)
• Brady Robert Dorn, DC
• Roby Christian Dorn, D.C.
• DRS. Leaman, Setnicar & Piacsek, S.C.
• Joann C Dudley, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.