Samantha J Dawalt, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5487-12 Issued in WI

Practice address

637 Main St
Luxemburg, WI 54217-1125

Phone

(920) 845-5645

Fax

(920) 845-5640

NPI assigned

Nov 21, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kirchman Chiropractic LLCGroup PAC ID 9931158961, 2 clinicians

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.

• Kirchman Chiropractic, LLC

  • Chiropractor
  • Luxemburg, WI
  • NPI 1982772729
  Medicare reassignment Care Compare group NPD Authorized official
• Kewaunee Chiropractic Works LLC

  • Chiropractor
  • Kewaunee, WI
  • NPI 1063618502
  NPD

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1891331104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "LUXEMBURG",
            "state": "WI",
            "postal_code": "542170236",
            "telephone_number": "920-845-5654",
            "fax_number": "920-845-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 MAIN ST",
            "city": "LUXEMBURG",
            "state": "WI",
            "postal_code": "542171125",
            "telephone_number": "920-845-5645",
            "fax_number": "920-845-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWALT",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5487-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Angela Bouvette, LPN
• Bredael Family Chiropractic
• William Joseph Bredael, B.S., D.C.
• Brighter Routes Transportation LLC
• Guy Dawalt, DC
• Ann Marie Deprey, M.S., CCC-SLP
• Gina Enderby
• Elyse Marie Engebose, FNP-C
• Eye & Vision Clinics, S.C.
• Fred & Mamie's Home, Inc

• Chiropractor in Luxemburg, WI
• Providers in Luxemburg, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.