Randall W. Nodorft, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4057 Issued in WI

Practice address

884 S Janesville St
Suite C
Whitewater, WI 53190-2508

Phone

(262) 472-9115

NPI assigned

Oct 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Clinical Chiropractic of Whitewater, S.C.

  • Chiropractor
  • Whitewater, WI
  • NPI 1710172556
  Authorized official Same address or phone

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760564926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 TOWN HALL RD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535119770",
            "telephone_number": "608-362-7693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 S JANESVILLE ST",
            "address_2": "SUITE C",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531902508",
            "telephone_number": "262-472-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NODORFT",
        "first_name": "RANDALL",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "743131825015",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Morris
• Melissa Ruth Nelson Pinzino
• Elizabeth Neubauer
• Craig L Nevermann, OD
• Newleaf Services LLC
• Donald Michael Norman, PH.D., LPC, LMFT
• Roy Alan Nosek, DDS
• Serif Odobasic, PHARMD
• Sandra Lynn Olds, PTA
• Angela Deanne Palmer, MS CCC-SLP

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

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.