Individual provider Active NPI

Brad K Freitag, DC

  • Chiropractor
  • Belleville, WI
National Provider Identifier
1902833957
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3786-012 Issued in WI
Practice address
1019 River St
Suite 5
Belleville, WI 53508-9181
Phone
(608) 424-1840
Fax
(608) 424-1815
NPI assigned
Jun 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 3786-012 WI Primary

Addresses

Primary practice location

1019 River St
Suite 5
Belleville, WI 53508-9181

Mailing address

1019 River St
Suite 5
Belleville, WI 53508-9181
Phone (608) 424-1840

Other identifiers 1

IdentifierTypeStateIssuer
38932700MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070816000251 WI Practitioner - Chiropractic 7113019415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Belleville Chiropractic and Wellness Center, S.C.Group PAC ID 1658463955, 2 clinicians

Practice addresses (Care Compare)

1100 Bellwest Blvd
Belleville, WI 53508-9433
Phone (608) 424-1840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3786-012WIMDChiropractor

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902833957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 RIVER ST",
            "address_2": "SUITE 5",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089181",
            "telephone_number": "608-424-1840",
            "fax_number": "608-424-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 RIVER ST",
            "address_2": "SUITE 5",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089181",
            "telephone_number": "608-424-1840",
            "fax_number": "608-424-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREITAG",
        "first_name": "BRAD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3786-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38932700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, 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.
  • 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.