Krystal Rae Davis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4559-12 Issued in WI

Practice address

1925 E Main St
Little Chute, WI 54140-2457

Phone

(920) 462-4630

Fax

(920) 759-5165

NPI assigned

Dec 11, 2009

Sex

Female

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

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Davis Family Chiropractic LLC

  • Chiropractor
  • Little Chute, WI
  • NPI 1740775279
  Medicare reassignment NPD Authorized official

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1780913202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 E MAIN ST",
            "city": "LITTLE CHUTE",
            "state": "WI",
            "postal_code": "541402457",
            "telephone_number": "920-462-4630",
            "fax_number": "920-759-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 E MAIN ST",
            "city": "LITTLE CHUTE",
            "state": "WI",
            "postal_code": "541402457",
            "telephone_number": "920-462-4630",
            "fax_number": "920-759-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KRYSTAL",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-11",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4559-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780913202",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cory Briggs
• James Brotz
• Melissa A Chambers, LPC
• Ronald James Collard, R.PH.
• Davis Family Chiropractic LLC
• Jessica Demerath
• Ebben & Pynenberg DDS SC
• Michael Charles Ebben, DDS
• Elite Smiles Little Chute, LLC
• Amy Marie Fifield, LPC SASA

• All providers in Little Chute, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.