Active NPI
Robert William Miclot Jr., DC
- Chiropractor
- Brookfield, WI
National Provider Identifier
1871694539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2689
- Practice address
- 17495 W Capitol Dr
Brookfield, WI 53045 - Phone
- (262) 790-4900
- Fax
- (262) 790-4900
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2689 | WI | Primary |
Addresses
Primary practice location
17495 W Capitol Dr
Brookfield, WI 53045
Mailing address
8216 N 38TH St
Brown Deer, WI 53209
Phone (414) 362-0880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38865700 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871694539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8216 N 38TH ST",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "53209",
"telephone_number": "414-362-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17495 W CAPITOL DR",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "53045",
"telephone_number": "262-790-4900",
"fax_number": "262-790-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICLOT",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"name_suffix": "Jr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "2689",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38865700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.