Organization Active NPI

Delafield Chiropractic LLC

  • Chiropractor
  • Delafield, WI
National Provider Identifier
1821271263
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3558 Issued in WI
Legal business name
DELAFIELD CHIROPRACTIC LLC
Practice address
403 Genesee St
Delafield, WI 53018-1814
Phone
(262) 646-6400
Fax
(262) 646-6443
NPI assigned
Dec 7, 2007
Last updated
Feb 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Dr. Michelle A. Matson-Riegleman, D.C.
Title
Owner
Phone
(262) 646-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3558 WI Primary

Addresses

Primary practice location

403 Genesee St
Delafield, WI 53018-1814

Mailing address

403 Genesee St
Delafield, WI 53018-1814
Phone (262) 646-6400

Other identifiers 1

IdentifierTypeStateIssuer
3558OtherWISTATE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080313000719 WI Part B Supplier - Clinic/Group Practice 5193800100 Receives reassigned benefits from 2 practitioners
Practice locations: Delafield, WI

National Provider Directory

National Provider Directory

Locations

403 Genesee St
Delafield, WI 53018
Phone (262) 646-6400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1821271263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 GENESEE ST",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181814",
            "telephone_number": "262-646-6400",
            "fax_number": "262-646-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 GENESEE ST",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181814",
            "telephone_number": "262-646-6400",
            "fax_number": "262-646-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAFIELD CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "MATSON-RIEGLEMAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-646-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "3558",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delafield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.