Individual provider Active NPI

Christopher Paul Rebholz, D.C.

  • Orthopedic Chiropractor
  • Pewaukee, WI
National Provider Identifier
1861425928
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
4172-012 Issued in WI
Practice address
690 Westfield Way Ste F
Pewaukee, WI 53072-2585
Phone
(262) 691-0997
Fax
(262) 875-3593
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 4172-012 WI Primary

Addresses

Primary practice location

690 Westfield Way Ste F
Pewaukee, WI 53072-2585

Mailing address

690 Westfield Way Ste F
Pewaukee, WI 53072-2585
Phone (262) 691-0997

Other practice location 1

W238N1690 Rockwood Dr Ste 200
Waukesha, WI 53188-1151
Phone (262) 691-0997

Other identifiers 1

IdentifierTypeStateIssuer
38970200MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061219000548 WI Practitioner - Chiropractic 4385643485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

690 Westfield Way
Suite F
Pewaukee, WI 53072-2585
Phone (262) 691-0997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Chiropractors, LLC CurrentSince Jul 1, 2006 Accepting new patients

Locations

690 Westfield Way
Ste F
Pewaukee, WI 53072
Phone (262) 219-5290

2900 Golf Rd
Pewaukee, WI 53072
Phone (262) 513-7254

W238N1690 Rockwood Dr
Ste 200
Waukesha, WI 53188
Phone (262) 691-0997

Organizations & group practices 1

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1861425928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 WESTFIELD WAY STE F",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530722585",
            "telephone_number": "262-691-0997",
            "fax_number": "262-875-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 WESTFIELD WAY STE F",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530722585",
            "telephone_number": "262-691-0997",
            "fax_number": "262-875-3593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W238N1690 Rockwood Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531881151",
            "country_code": "US",
            "telephone_number": "262-691-0997",
            "fax_number": "262-875-3593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REBHOLZ",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "WI",
            "license": "4172-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38970200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.