Delorey Chiropractic Clinic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3678-012 Issued in WI

Legal business name

DELOREY CHIROPRACTIC CLINIC, INC.

Practice address

1488 Mid Valley Dr
De Pere, WI 54115-9501

Phone

(920) 965-6600

Fax

(920) 965-6601

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Nathan D Delorey, D.O.NPI 1972794022

Title

President

Phone

(920) 965-6600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

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

• Nathan Daniel Delorey, D.C.

  • Chiropractor
  • De Pere, WI
  • NPI 1972794022
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1922188440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 MID VALLEY DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159501",
            "telephone_number": "920-965-6600",
            "fax_number": "920-965-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 MID VALLEY DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159501",
            "telephone_number": "920-965-6600",
            "fax_number": "920-965-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELOREY CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "DELOREY",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-965-6600",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3678-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38935600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• De Pere Chiropractic Center, LLC (De Pere Chiropractic Center)
• De Pere Family Dentistry LLC
• De Pere Hometown Pharmacy LLC (De Pere Hometown Pharmacy)
• De Pere Smiles Acquisition Company S.C. (De Pere Smiles S.C.)
• Janet Katharina Deleers
• Nathan Daniel Delorey, D.C.
• Den Dia IV (Stowe Drug Store)
• Jennifer Lynn Deneys, PT
• Kelly J. Depas, MSPT
• Katie Depeau, DPT

• Chiropractor in De Pere, WI
• Providers in De Pere, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.