Individual provider Active NPI

John D Schubbe, DC

  • Chiropractor
  • Appleton, WI
National Provider Identifier
1962587576
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2322012 Issued in WI
Practice address
2200 S Kensington Drive
Appleton, WI 54915
Phone
(920) 738-0200
Fax
(920) 738-0383
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2322012 WI Primary

Addresses

Primary practice location

2200 S Kensington Drive
Appleton, WI 54915

Mailing address

2200 S Kensington Drive
Appleton, WI 54915
Phone (920) 738-0200

Other identifiers 1

IdentifierTypeStateIssuer
38851300MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101220000586 WI Practitioner - Chiropractic 8527034651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schubbe Family Chiropractic LTDGroup PAC ID 2668448879, 7 clinicians

Practice addresses (Care Compare)

2200 S Kensington Dr
Appleton, WI 54915-4144
Phone (920) 738-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2322012WIMDChiropractor
2322WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Schubbe Family Chiropractic LTD Chiropractor CurrentSince Aug 1, 1999 Accepting new patients
Radiology Associates of the Fox Valley, SC Past Accepting new patients

Locations

2200 S Kensington Dr
Appleton, WI 54915
Phone (920) 738-0200

Organizations & group practices 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1962587576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 S KENSINGTON DRIVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54915",
            "telephone_number": "920-738-0200",
            "fax_number": "920-738-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 S KENSINGTON DRIVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54915",
            "telephone_number": "920-738-0200",
            "fax_number": "920-738-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUBBE",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2322012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38851300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.