Individual provider Active NPI

Daniel Robert Smith, D.C, M.S.

  • Chiropractor
  • Marinette, WI
National Provider Identifier
1982964904
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5201-12 Issued in WI
Practice address
3117 Shore Dr
Marinette, WI 54143-4293
Phone
(712) 732-5105
NPI assigned
May 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5201-12 WI Primary

Addresses

Primary practice location

3117 Shore Dr
Marinette, WI 54143-4293

Mailing address

1713 Dunlap Ave
Apt 319
Marinette, WI 54143-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5201-12WIMDChiropractor
14052TXMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Champion Health Associates, LLC Chiropractor PastSince Dec 1, 2007 Accepting new patients

Organizations & group practices 1

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": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1982964904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 DUNLAP AVE",
            "address_2": "APT 319",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 SHORE DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434293",
            "telephone_number": "712-732-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-23",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5201-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.