Organization Active NPI

Early Clinic of Chiropractic LLC

  • Chiropractor
  • Fond Du Lac, WI
National Provider Identifier
1922207612
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EARLY CLINIC OF CHIROPRACTIC LLC
Practice address
1211 Rickmeyer Dr
Fond Du Lac, WI 54937-2213
Phone
(920) 322-9594
Fax
(920) 322-9676
NPI assigned
Jul 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Dr. James Andrew Early, D.C.NPI 1386785574
Title
Owner
Phone
(920) 322-9594

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 Primary

Addresses

Primary practice location

1211 Rickmeyer Dr
Fond Du Lac, WI 54937-2213

Mailing address

1211 Rickmeyer Dr
Fond Du Lac, WI 54937-2213
Phone (920) 322-9594

Other identifiers 1

IdentifierTypeStateIssuer
38950600MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050127000491 WI Part B Supplier - Clinic/Group Practice 4880644889 Receives reassigned benefits from 1 practitioner
Practice locations: Fond Du Lac, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2073179Early Clinic of Chiropractic LLC1211 Rickmeyer Dr, Suite F, Fond Du Lac, WI 54937Certificate of waiverFeb 11, 2028

National Provider Directory

National Provider Directory

Locations

1211 Rickmeyer Dr
Ste F
Fond du Lac, WI 54937
Phone (920) 322-9594

1211 Rickmeyer Dr
Fond du Lac, WI 54937
Phone (920) 322-9594

Practitioners & affiliated clinicians

Practitioners 1

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": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1922207612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 RICKMEYER DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549372213",
            "telephone_number": "920-322-9594",
            "fax_number": "920-322-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 RICKMEYER DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549372213",
            "telephone_number": "920-322-9594",
            "fax_number": "920-322-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY CLINIC OF CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "EARLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-322-9594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38950600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.