Chiro-Med West Town SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2219 Issued in WI

Legal business name

CHIRO-MED WEST TOWN SC

Practice address

6708 Odana Rd
Ste B
Madison, WI 53719-1066

Phone

(608) 826-9090

NPI assigned

Oct 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Dale W Brockman, DC

Title

Chiropractor

Phone

(608) 826-9090

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293667200000",
    "number": "1942499520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6708 ODANA RD",
            "address_2": "STE B",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191066",
            "telephone_number": "608-826-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6708 ODANA RD",
            "address_2": "STE B",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191066",
            "telephone_number": "608-826-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO-MED WEST TOWN SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2010-12-30",
        "status": "A",
        "authorized_official_last_name": "BROCKMAN",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "608-826-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38798900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiro One Wellness Center of Madison East, LLC
• Chiro One Wellness Center of Madison West, LLC
• Chiropractic Solutions
• Chiropractic Solutions Inc
• Chiropractic Works LLC
• Gregory W Chism, MSW LCSW
• Amit Satish Chitnis, MD

• Chiropractor in Madison, WI
• Providers in Madison, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.