Organization Active NPI

Wilke Chiropractic Office SC

  • Chiropractor
  • Evansville, WI
National Provider Identifier
1861683336
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3895 012 Issued in WI
Legal business name
WILKE CHIROPRACTIC OFFICE SC
Practice address
503 East Main Street
Evansville, WI 53536-1131
Phone
(608) 882-4146
Fax
(608) 882-4010
NPI assigned
Aug 8, 2007
Last updated
Aug 8, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Authorized official

Name
Dr. Peter John Wilke, DCNPI 1134289242
Title
Owner
Phone
(608) 882-4146

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3895 012 WI Primary

Addresses

Primary practice location

503 East Main Street
Evansville, WI 53536-1131

Mailing address

503 East Main Street
Evansville, WI 53536-1131
Phone (608) 882-4146

Other identifiers 2

IdentifierTypeStateIssuer
38941900MedicaidWI
534673OtherDEAN HEALTH PLAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101229000258 WI Part B Supplier - Clinic/Group Practice 8426246869 Receives reassigned benefits from 3 practitioners
Practice locations: Evansville, WI

National Provider Directory

National Provider Directory

Locations

802B 23rd St
Brodhead, WI 53520
Phone (608) 897-3010

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186531200000",
    "number": "1861683336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 EAST MAIN STREET",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361131",
            "telephone_number": "608-882-4146",
            "fax_number": "608-882-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 EAST MAIN STREET",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361131",
            "telephone_number": "608-882-4146",
            "fax_number": "608-882-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILKE CHIROPRACTIC OFFICE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "WILKE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-882-4146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3895 012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38941900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "534673",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.