Organization Active NPI

Friederichs Chiropractic LLC

  • Chiropractor
  • Sheboygan, WI
National Provider Identifier
1972033082
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4742-12 Issued in WI
Legal business name
FRIEDERICHS CHIROPRACTIC LLC
Practice address
604 Michigan Ave
Sheboygan, WI 53081-3425
Phone
(920) 459-8475
Fax
(920) 694-0437
NPI assigned
Jun 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Kyle J Friederichs, DCNPI 1689963472
Title
Owner
Phone
(920) 459-8475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4742-12 WI Primary

Addresses

Primary practice location

604 Michigan Ave
Sheboygan, WI 53081-3425

Mailing address

604 Michigan Ave
Sheboygan, WI 53081-3425
Phone (920) 459-8475

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171205001751 WI Part B Supplier - Clinic/Group Practice 5193082857 Receives reassigned benefits from 2 practitioners
Practice locations: Sheboygan, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972033082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 MICHIGAN AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813425",
            "telephone_number": "920-459-8475",
            "fax_number": "920-694-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 MICHIGAN AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813425",
            "telephone_number": "920-459-8475",
            "fax_number": "920-694-0437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIEDERICHS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FRIEDERICHS",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-459-8475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4742-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.