Caleb Michael Fedewa, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5546-12 Issued in WI

Practice address

420 N Chestnut Ave Ste B
Oconto Falls, WI 54154-1109

Phone

(920) 848-2392

Fax

(920) 239-8135

NPI assigned

Nov 27, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Atlas Aligned LLC

  • Chiropractor
  • Oconto Falls, WI
  • NPI 1265030589
  Medicare reassignment NPD Authorized official
• The Center for Comprehensive Chiropractic Care

  • Chiropractor
  • Oconto Falls, WI
  • NPI 1114335536
  NPD
• Pure Health, LLC

  • Chiropractor
  • Minneapolis, MN
  • NPI 1073855953
  NPD

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1881230688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N CHESTNUT AVE STE B",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541109",
            "telephone_number": "920-848-2392",
            "fax_number": "920-239-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N CHESTNUT AVE STE B",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541109",
            "telephone_number": "920-848-2392",
            "fax_number": "920-239-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDEWA",
        "first_name": "CALEB",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-27",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5546-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drfedewa@purehealthmn.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "945 Broadway St NE Ste 275",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554132600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca Decker, PTA
• Randel Gene Dietze, D.D.S.
• Donald L Ryszka OD
• Diane M Dreshek, NP
• Emcare Physician Providers, Inc.
• Dawn Fifarek, C.R.N.A.
• Lisa May Fonder, FNP-C, APNP
• Forefront Dermatology, S.C.
• Becky Harlene Gaertig, REGISTERED NURSE
• Cheryl Garner

• Chiropractor in Oconto Falls, WI
• Providers in Oconto Falls, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.