Individual provider Active NPI

Thomas Nathan Ogi, DC

  • Chiropractor
  • Kewaskum, WI
National Provider Identifier
1932490364
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4743-012 Issued in WI
Practice address
1040 Fond Du Lac Ave
Kewaskum, WI 53040-9590
Phone
(262) 477-1040
Fax
(262) 247-0645
NPI assigned
Apr 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4743-012 WI Primary

Addresses

Primary practice location

1040 Fond Du Lac Ave
Kewaskum, WI 53040-9590

Mailing address

1040 Fond Du Lac Ave
Kewaskum, WI 53040-9590
Phone (262) 477-1040

Other identifiers 1

IdentifierTypeStateIssuer
100020814MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000545 WI Practitioner - Chiropractic 9234304155 Reassigns benefits to 1 organization
Practice locations: Kewaskum, WI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern University Feinberg Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1040 Fond Du Lac Ave
Kewaskum, WI 53040-9590
Phone (262) 477-1040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4743-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ogi Chiropractic, Inc Chiropractor CurrentSince Aug 24, 2019 Accepting new patients

Locations

1040 Fond du Lac Ave
Ste 3
Kewaskum, WI 53040

1040 Fond du Lac Ave
Ste A
Kewaskum, WI 53040

1040 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 477-1040

1040 Fond du Lac Ave
#A
Kewaskum, WI 53040
Phone (262) 483-1448

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1932490364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FOND DU LAC AVE",
            "city": "KEWASKUM",
            "state": "WI",
            "postal_code": "530409590",
            "telephone_number": "262-477-1040",
            "fax_number": "262-247-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 FOND DU LAC AVE",
            "city": "KEWASKUM",
            "state": "WI",
            "postal_code": "530409590",
            "telephone_number": "262-477-1040",
            "fax_number": "262-247-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGI",
        "first_name": "THOMAS",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4743-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100020814",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kewaskum, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.