BELLEVUE TOTAL HEALTH SC NPI 1447203013

NPI Information

NPI: 1447203013
Provider Name: BELLEVUE TOTAL HEALTH, SC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
2763 MANITOWOC RD
STE B
GREEN BAY, WI
ZIP 54311
Phone: (920) 468-8288
Get Directions

BELLEVUE TOTAL HEALTH, SC is a chiropractor in Green Bay, WI. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. BELLEVUE TOTAL HEALTH, SC NPI is 1447203013. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2763 MANITOWOC RD
STE B
GREEN BAY, WI
ZIP 54311-633
Phone: (920) 468-8288
Fax: (920) 468-9887

The provider's authorized official is Bradley J Kenny .
The authorized official title is Owner/chiropractor and has the following contact phone number (920) 468-8288.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		2502-012	WISCONSIN	Yes
2	111N00000X	Chiropractor		4214-012	WISCONSIN	X
3	207R00000X	Internal Medicine		25884-020	WISCONSIN	X
4	363LX0106X	Nurse Practitioner	Occupational Health	1221-033	WISCONSIN	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	21250700	MEDICAID	WISCONSIN
2	39002800	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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