Individual provider Active NPI

Chad James Skogstad, D.C.

  • Sports Physician Chiropractor
  • Eau Claire, WI
National Provider Identifier
1992877195
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
3346-012 Issued in WI
Practice address
4606 Commerce Valley Rd
Suite 209
Eau Claire, WI 54701-7074
Phone
(715) 832-6616
Fax
(715) 832-6454
NPI assigned
Nov 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 3346-012 WI Primary

Addresses

Primary practice location

4606 Commerce Valley Rd
Suite 209
Eau Claire, WI 54701-7074

Mailing address

4606 Commerce Valley Rd
Suite 209
Eau Claire, WI 54701-7074
Phone (715) 832-6616

Other identifiers 1

IdentifierTypeStateIssuer
38892500MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040508000267 WI Practitioner - Chiropractic 2567451206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eau Claire Chiropractic SCGroup PAC ID 3072502707, 4 clinicians

Practice addresses (Care Compare)

4606 Commerce Valley Rd
Suite 209
Eau Claire, WI 54701-7075
Phone (715) 832-6616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3346-012WIMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eau Claire Chiropractic, SC CurrentSince Jun 1, 2004 Accepting new patients

Locations

4606 Commerce Valley Rd
Ste 209
Eau Claire, WI 54701
Phone (715) 832-6616

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992877195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 COMMERCE VALLEY RD",
            "address_2": "SUITE 209",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017074",
            "telephone_number": "715-832-6616",
            "fax_number": "715-832-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 COMMERCE VALLEY RD",
            "address_2": "SUITE 209",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017074",
            "telephone_number": "715-832-6616",
            "fax_number": "715-832-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOGSTAD",
        "first_name": "CHAD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WI",
            "license": "3346-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38892500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.