NPIMap

Organization Active NPI

Howard Chiropractic Clinic, S.C.

  • Orthopedic Chiropractor
  • Green Bay, WI
National Provider Identifier
1831363431
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
2312 Issued in WI
Legal business name
HOWARD CHIROPRACTIC CLINIC, S.C.
Practice address
721 Cardinal LN
Ste 100
Green Bay, WI 54313-3216
Phone
(920) 434-2221
Fax
(920) 434-2483
NPI assigned
Apr 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Authorized official

Name
Dennis King, DCNPI 1255411302
Title
Owner
Phone
(920) 434-2221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NP0017X 3015 WI
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 4133 WI
Orthopedic ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0800X 2312 WI Primary

Addresses

Primary practice location

721 Cardinal LN
Ste 100
Green Bay, WI 54313-3216

Mailing address

721 Cardinal LN
Ste 100
Green Bay, WI 54313-3216
Phone (920) 434-2221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412000233 WI Part B Supplier - Clinic/Group Practice 8123012465 Receives reassigned benefits from 3 practitioners
Practice locations: Green Bay, WI

National Provider Directory

National Provider Directory

Locations

721 Cardinal Ln
Ste 100
Green Bay, WI 54313
Phone (920) 434-2221

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356048000000",
    "number": "1831363431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 CARDINAL LN",
            "address_2": "STE 100",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543133216",
            "telephone_number": "920-434-2221",
            "fax_number": "920-434-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 CARDINAL LN",
            "address_2": "STE 100",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543133216",
            "telephone_number": "920-434-2221",
            "fax_number": "920-434-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD CHIROPRACTIC CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2012-12-21",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-434-2221",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "WI",
            "license": "3015",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WI",
            "license": "4133",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "WI",
            "license": "2312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; 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.