Organization Active NPI

Weber Chiropractic Clinic SC

  • Chiropractor
  • Prairie Du Chien, WI
National Provider Identifier
1912119173
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3386-012 Issued in WI
Legal business name
WEBER CHIROPRACTIC CLINIC SC
Practice address
601 E Blackhawk Ave
Prairie Du Chien, WI 53821
Phone
(608) 326-2511
Fax
(608) 326-2167
NPI assigned
May 3, 2007
Last updated
Mar 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Authorized official

Name
Alan J Weber, D.C.NPI 1215991971
Title
Doctor
Phone
(608) 326-2511

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
Chiropractor 111N00000X 3386-012 WI Primary

Addresses

Primary practice location

601 E Blackhawk Ave
Prairie Du Chien, WI 53821

Mailing address

62800 Collins LN
Prairie Du Chien, WI 53821
Phone (608) 326-8792

Other identifiers 2

IdentifierTypeStateIssuer
38896800MedicaidWI
350038301OtherWIRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110310000093 WI Part B Supplier - Clinic/Group Practice 0446432587 Receives reassigned benefits from 1 practitioner
Practice locations: Prairie Du Chien, WI

National Provider Directory

National Provider Directory

Locations

601 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-2511

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1912119173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62800 COLLINS LN",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "53821",
            "telephone_number": "608-326-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E BLACKHAWK AVE",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "53821",
            "telephone_number": "608-326-2511",
            "fax_number": "608-326-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBER CHIROPRACTIC CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "608-326-2511",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3386-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38896800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350038301",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Du Chien, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.