Individual provider Active NPI

Marissa Dawn Kaul, DC

  • Chiropractor
  • Racine, WI
National Provider Identifier
1861248577
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6179-012 Issued in WI
Practice address
2609 Rapids Dr
Racine, WI 53404-1741
Phone
(262) 638-9999
Fax
(262) 638-0742
NPI assigned
Apr 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6179-012 WI Primary

Addresses

Primary practice location

2609 Rapids Dr
Racine, WI 53404-1741

Mailing address

2609 Rapids Dr
Racine, WI 53404-1741
Phone (262) 638-9999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240514000444 WI Practitioner - Chiropractic 9537500186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniels Chiropractic Office IncGroup PAC ID 6406923200, 5 clinicians

Practice addresses (Care Compare)

2609 Rapids Dr
Racine, WI 53404-1741
Phone (262) 638-9999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6179-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Daniels Chiropractic Office Inc CurrentSince Apr 29, 2024 Accepting new patients
Chiropractic Company - Mke Downtown LTD Chiropractor PastSince Apr 28, 2024 Accepting new patients

Locations

2609 Rapids Dr
Racine, WI 53404
Phone (262) 638-9999

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1861248577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 RAPIDS DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534041741",
            "telephone_number": "262-638-9999",
            "fax_number": "262-638-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 RAPIDS DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534041741",
            "telephone_number": "262-638-9999",
            "fax_number": "262-638-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUL",
        "first_name": "MARISSA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6179-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.