NPIMap

Organization Active NPI

Lifestyle Chiropractic & Wellness Connection LLC

  • Chiropractor
  • Green Bay, WI
National Provider Identifier
1891897328
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3788012 Issued in WI
Legal business name
LIFESTYLE CHIROPRACTIC & WELLNESS CONNECTION LLC
Practice address
2301 Holmgren Way Ste 1
Green Bay, WI 54304-5270
Phone
(715) 499-3333
Fax
(715) 884-7495
NPI assigned
Sep 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Dr. Chad Mathew Hoffman, D.C.NPI 1780676627
Title
Owner
Phone
(920) 499-3333

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3788012 WI Primary

Addresses

Primary practice location

2301 Holmgren Way Ste 1
Green Bay, WI 54304-5270

Mailing address

1671 Hoffman Rd Ste 170
Green Bay, WI 54311-6232
Phone (920) 499-3333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040728000027 WI Part B Supplier - Clinic/Group Practice 9739159716 Receives reassigned benefits from 3 practitioners
Practice locations: Green Bay, WI

National Provider Directory

National Provider Directory

Locations

2301 Holmgren Way
Ste 1
Green Bay, WI 54304
Phone (715) 499-3333

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1891897328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1671 HOFFMAN RD STE 170",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116232",
            "telephone_number": "920-499-3333",
            "fax_number": "920-482-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOLMGREN WAY STE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045270",
            "telephone_number": "715-499-3333",
            "fax_number": "715-884-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE CHIROPRACTIC & WELLNESS CONNECTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-04",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-499-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3788012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.