Healthcare Provider Details

I. General information

NPI: 1417167115
Provider Name (Legal Business Name): CHIRO-MED,SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N21W23340 RIDGEVIEW PKWY W STE 110
WAUKESHA WI
53188-1021
US

IV. Provider business mailing address

N21W23340 RIDGEVIEW PKWY W STE 110
WAUKESHA WI
53188-1021
US

V. Phone/Fax

Practice location:
  • Phone: 262-542-4700
  • Fax: 262-542-7499
Mailing address:
  • Phone: 262-542-4700
  • Fax: 262-542-7499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number43273-020
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2362
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2155
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3571
License Number StateWI

VIII. Authorized Official

Name: DR. JAMES A ROPICKY
Title or Position: PRESIDENT
Credential: DC
Phone: 262-542-4700