Individual provider Active NPI

Christopher John Simons, CHRISTOPHER SIMONS

  • Chiropractor
  • Two Rivers, WI
National Provider Identifier
1811078413
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3351 Issued in WI
Practice address
3009 Forest Ave
Two Rivers, WI 54241-1926
Phone
(192) 079-3449
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3351 WI Primary

Addresses

Primary practice location

3009 Forest Ave
Two Rivers, WI 54241-1926

Mailing address

3009 Forest Ave
Two Rivers, WI 54241-1926
Phone (192) 079-3449

Other names 1

  • Dr. Christopher John Simons Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040916000099 WI Practitioner - Chiropractic 1153398383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3009 Forest Ave
Two Rivers, WI 54241-1926
Phone (920) 793-4498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3351WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Chiropractic, S.C. Chiropractor CurrentSince Aug 28, 2004 Accepting new patients

Locations

3009 Forest Ave
Two Rivers, WI 54241
Phone (920) 793-4498

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811078413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 FOREST AVE",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542411926",
            "telephone_number": "192-079-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 FOREST AVE",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542411926",
            "telephone_number": "192-079-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "CHRISTOPHER SIMONS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTOPHER",
            "last_name": "SIMONS",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "credential": "CHRISTOPHER SIMONS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Two Rivers, WI

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.
  • 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.