Individual provider Active NPI

Travis Beauchamp, D.C.

  • Chiropractor
  • Hudson, WI
National Provider Identifier
1821119934
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4313 Issued in WI
Practice address
1810 Webster St
Suite 2
Hudson, WI 54016-9305
Phone
(715) 386-6100
Fax
(715) 386-6298
NPI assigned
Apr 3, 2007
Last updated
Sep 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4935 MN
Chiropractor 111N00000X 4313 WI Primary

Addresses

Primary practice location

1810 Webster St
Suite 2
Hudson, WI 54016-9305

Mailing address

1810 Webster St
Suite 2
Hudson, WI 54016-9305
Phone (715) 386-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141002000201 MI Practitioner - Chiropractic 4789785502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 Ludington St
Escanaba, MI 49829-3926
Phone (906) 786-5520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4313WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beauchamp Chiropractic Chiropractor CurrentSince Sep 19, 2014 Accepting new patients
Delta Chiropractic Associates,Inc Chiropractor PastSince Nov 1, 2004 Accepting new patients
Hudson Chiropractic, S.C. Chiropractor Past Accepting new patients

Locations

218 S 10th St
Escanaba, MI 49829
Phone (612) 386-7709

500 Ludington St
Escanaba, MI 49829
Phone (906) 786-5520

Organizations & group practices 4

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1821119934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 WEBSTER ST",
            "address_2": "SUITE 2",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169305",
            "telephone_number": "715-386-6100",
            "fax_number": "715-386-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 WEBSTER ST",
            "address_2": "SUITE 2",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169305",
            "telephone_number": "715-386-6100",
            "fax_number": "715-386-6298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCHAMP",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4935",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.