Douglas Robert Schildt, D.C., S.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1452-12 Issued in WI

Legal business name

DOUGLAS ROBERT SCHILDT, D.C., S.C.

Doing business as

HealthSource of Fort Atkinson

Practice address

1000 Madison Ave
Fort Atkinson, WI 53538-1326

Phone

(920) 563-9295

Fax

(920) 563-9360

NPI assigned

Dec 10, 2010

Last updated

Dec 10, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas Robert Schildt, D.C.NPI 1689660516

Title

President

Phone

(920) 563-9360

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HealthSource of Fort Atkinson Doing business as

Locations

Practitioners 1

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.

• Douglas R Schildt, DC

  • Chiropractor
  • Fort Atkinson, WI
  • NPI 1689660516
  Authorized official Same address or phone

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291939200000",
    "number": "1942503123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MADISON AVE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381326",
            "telephone_number": "920-563-9295",
            "fax_number": "920-563-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MADISON AVE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381326",
            "telephone_number": "920-563-9295",
            "fax_number": "920-563-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS ROBERT SCHILDT, D.C., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2010-12-10",
        "status": "A",
        "authorized_official_last_name": "SCHILDT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-563-9360",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1452-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38757400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource of Fort Atkinson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Janet K Dickinson
• John P Doerfer, M.D.
• Geralyn Carol Dorn
• Carol Dougherty, RN
• Michael D Dougherty, P.A.
• McKayla Marie Drew, APSW
• Kathryn Gayle Dunkel, DPT
• Dycora Transitional Health - Fort Atkinson LLC
• Hannah Dyer, COTA/L
• E C Jiongco, MD, SC

• Chiropractor in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Chiropractor in Wisconsin

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