Individual provider Active NPI

Christopher Peter Limbach, DOCTOR OF CHIROPRACT

  • Chiropractor
  • Kenosha, WI
National Provider Identifier
1811013329
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3720012 Issued in WI
Practice address
3916 67TH St
Kenosha, WI 53142
Phone
(262) 605-4770
Fax
(262) 605-4774
NPI assigned
Mar 22, 2007
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3720012 WI Primary

Addresses

Primary practice location

3916 67TH St
Kenosha, WI 53142

Mailing address

3916 67TH St
Kenosha, WI 53142-3808
Phone (262) 605-4770

Other identifiers 1

IdentifierTypeStateIssuer
1811013329MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071220000180 WI Practitioner - Chiropractic 0345330882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3916 67TH St
Kenosha, WI 53142-3808
Phone (262) 605-4770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3720012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Limbach Family Chiropractic, LLC Chiropractor CurrentSince Jan 5, 2002 Accepting new patients

Locations

3916 67th St
Kenosha, WI 53142
Phone (262) 605-4770

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1811013329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 67TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423808",
            "telephone_number": "262-605-4770",
            "fax_number": "262-605-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 67TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53142",
            "telephone_number": "262-605-4770",
            "fax_number": "262-605-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMBACH",
        "first_name": "CHRISTOPHER",
        "middle_name": "PETER",
        "credential": "DOCTOR OF CHIROPRACT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3720012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811013329",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.