Individual provider Active NPI

Orville Ammador Antonio, D.C.

  • Chiropractor
  • Sturgeon Bay, WI
National Provider Identifier
1992309348
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5354-12 Issued in WI
Practice address
30 N 18TH Ave Ste 5
Sturgeon Bay, WI 54235-3207
Phone
(920) 818-1234
NPI assigned
Nov 25, 2020
Sex
Male
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1034 Tacoma Beach Rd
Sturgeon Bay, WI 54235-1660

30 N 18TH Ave
Suite 5
Sturgeon Bay, WI 54235-3207
Phone (920) 818-1234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210924001296 WI Practitioner - Chiropractic 5597161174 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Antonio Natural Healing, LLC CurrentSince Jun 15, 2021 Accepting new patients

Locations

30 N 18th Ave
Ste 5
Sturgeon Bay, WI 54235
Phone (920) 818-1234

253 N 1st Ave
Stop 1H
Sturgeon Bay, WI 54235

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5354-12 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

30 N 18TH Ave Ste 5
Sturgeon Bay, WI 54235-3207

Mailing address

1034 Tacoma Beach Rd
Sturgeon Bay, WI 54235-1660
Phone (920) 818-1234

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 30, 2025.

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1992309348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 TACOMA BEACH RD",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351660",
            "telephone_number": "920-818-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 18TH AVE STE 5",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542353207",
            "telephone_number": "920-818-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "ORVILLE",
        "middle_name": "AMMADOR",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-25",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5354-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgeon Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.