Active NPI
Dan A Farah, DC
- Chiropractor
- Green Bay, WI
National Provider Identifier
1760405096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2090012
- Practice address
- 1330 Velp Ave
Green Bay, WI 54303 - Phone
- (920) 497-9499
- Fax
- (920) 497-5943
- NPI assigned
- Jul 26, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2090012 | WI | Primary |
Addresses
Primary practice location
1330 Velp Ave
Green Bay, WI 54303
Mailing address
1330 Velp Ave
Green Bay, WI 54303
Phone (920) 497-9499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38799600 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120426000029 | WI | Practitioner - Chiropractic | 2466614110 | Practice locations: Green Bay, WI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2090012 | WI | MD | Chiropractor |
| 2090 | WI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760405096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 VELP AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54303",
"telephone_number": "920-497-9499",
"fax_number": "920-497-5943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 VELP AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54303",
"telephone_number": "920-497-9499",
"fax_number": "920-497-5943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARAH",
"first_name": "DAN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "2090012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38799600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
- Family Services of Northeast Wisconsin Inc
- Family Services of Northeast Wisconsin, Inc.
- Family Services of Northeast Wisconsin, Inc.
- Family Services of Northeast, Inc.
- Edmund S. Fangman, M.D.
- Thomas M. Farley, M.D.
- Julie Anne Farrell, DDS
- Taresa B Fassbender, PA
- Jeanie Faught, RN, NP, PTA
- Tracy Jenifer Faust, M.A., LPC, SAC, NCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.