Duane Michael Fedewa, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3031 Issued in WI

Practice address

719 Vine St
Wisconsin Dells, WI 53965-1621

Phone

(608) 254-4731

Fax

(605) 253-9257

NPI assigned

May 21, 2007

Last updated

Mar 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1994

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1962610949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 VINE ST",
            "city": "WISCONSIN DELLS",
            "state": "WI",
            "postal_code": "539651621",
            "telephone_number": "608-254-4731",
            "fax_number": "605-253-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 VINE ST",
            "city": "WISCONSIN DELLS",
            "state": "WI",
            "postal_code": "539651621",
            "telephone_number": "608-254-4731",
            "fax_number": "605-253-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDEWA",
        "first_name": "DUANE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350038138",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Demiree Marie Dexter, LMT
• Diane Dobbs
• Karla Jean Donohue, COTA
• Renato T Faylona, MD
• Diana Marshall Fedewa, D.C.
• James L Forsythe, OD
• Kenneth G Forsythe, OD
• Katherine Gesteland
• Lara Nicole Ginter, APNP
• Susan Gorski, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.