Individual provider Active NPI

Laura Ann Dull, DC

  • Chiropractor
  • Waukesha, WI
National Provider Identifier
1831206879
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3572 Issued in WI
Practice address
310 W Saint Paul Ave
5
Waukesha, WI 53188-5119
Phone
(262) 542-9814
Fax
(262) 542-9826
NPI assigned
Aug 24, 2006
Last updated
Nov 6, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 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 3572 WI Primary

Addresses

Primary practice location

310 W Saint Paul Ave
5
Waukesha, WI 53188-5119

Mailing address

310 W Saint Paul Ave
5
Waukesha, WI 53188-5119
Phone (262) 542-9814

Other identifiers 1

IdentifierTypeStateIssuer
38920300MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080124000587 WI Practitioner - Chiropractic 4284716655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic Care Center-Waukesha,LLCGroup PAC ID 4183706344, 2 clinicians

Practice addresses (Care Compare)

811 N Grandview Blvd
Suite a
Waukesha, WI 53188-2894
Phone (262) 542-9814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care Center-Waukesha,LLC Chiropractor CurrentSince Apr 30, 2003 Accepting new patients
Chiropractic Care Centers, S.C. Chiropractor Past Accepting new patients

Locations

310 W Saint Paul Ave
Ste 5
Waukesha, WI 53188
Phone (262) 542-9814

811 N Grandview Blvd
Ste A
Waukesha, WI 53188
Phone (262) 542-9814

Organizations & group practices 2

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1831206879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W SAINT PAUL AVE",
            "address_2": "5",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885119",
            "telephone_number": "262-542-9814",
            "fax_number": "262-542-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W SAINT PAUL AVE",
            "address_2": "5",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885119",
            "telephone_number": "262-542-9814",
            "fax_number": "262-542-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULL",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38920300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.