Individual provider Active NPI

David Stalheim, D.C.

  • Chiropractor
  • Marinette, WI
National Provider Identifier
1841244217
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3319-012 Issued in WI
Practice address
604 County Road T
Marinette, WI 54143-1064
Phone
(715) 735-9824
NPI assigned
May 20, 2006
Last updated
Jan 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3319-012 WI Primary

Addresses

Primary practice location

604 County Road T
Marinette, WI 54143-1064

Mailing address

604 County Road T
Marinette, WI 54143-1064
Phone (715) 735-9824

Other identifiers 1

IdentifierTypeStateIssuer
38893700MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000082 WI Practitioner - Chiropractic 4587567946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stalheim Chiropractic SCGroup PAC ID 0749264802, 2 clinicians

Practice addresses (Care Compare)

604 County Rd T
Marinette, WI 54143-9714
Phone (715) 735-9824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3319-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stalheim Chiropractic SC Chiropractor CurrentSince Jun 1, 1999 Accepting new patients
Thorp Family Chiropractic LLC Chiropractor Past Accepting new patients
Allied Health of Wisconsin, SC Chiropractor Past Accepting new patients

Locations

604 County Road T
Marinette, WI 54143
Phone (715) 735-9824

Organizations & group practices 3

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1841244217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 COUNTY ROAD T",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431064",
            "telephone_number": "715-735-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 COUNTY ROAD T",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431064",
            "telephone_number": "715-735-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALHEIM",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3319-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38893700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.