Individual provider Active NPI

Joseph J Antonie, DC

  • Chiropractor
  • Galesville, WI
National Provider Identifier
1881790202
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3388-012 Issued in WI
Practice address
16812 S 2ND St
Ste 120
Galesville, WI 54630-7295
Phone
(608) 582-4612
NPI assigned
Sep 15, 2006
Last updated
Oct 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3388-012 WI Primary

Addresses

Primary practice location

16812 S 2ND St
Ste 120
Galesville, WI 54630-7295

Mailing address

601 S 32ND Ave
Wausau, WI 54401-3958
Phone (715) 848-2526

Other identifiers 1

IdentifierTypeStateIssuer
38902100MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091104000047 WI Practitioner - Chiropractic 8628116175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16812 S 2ND St
Suite 120
Galesville, WI 54630-7322
Phone (608) 582-4612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3388-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Galesville Chiropractic LLC Chiropractor CurrentSince Jan 24, 2015 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1881790202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S 32ND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013958",
            "telephone_number": "715-848-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16812 S 2ND ST",
            "address_2": "STE 120",
            "city": "GALESVILLE",
            "state": "WI",
            "postal_code": "546307295",
            "telephone_number": "608-582-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIE",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3388-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38902100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.