DR. KEVIN A. BLAU (NPI# 1932194172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932194172 |
| Entity Type | Individual |
| Full Name | DR. KEVIN A. BLAU |
| Credential | D.C. |
| Practice Address |
641 Latton Ln Suite A Portage WI 53901-1078 |
| Practice Telephone | 6087421300 |
| Practice Fax Number | 6087450147 |
| Mailing Telephone | 6087421300 |
| Mailing Fax Number | 6087450147 |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2990 | WI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38887700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811494016 | Kevin Daniel Blau | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific St, Seattle, WA 98195 | 2018-04-12 |
| 1356724025 | Kevin Blau | Obstetrics & Gynecology | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2015-06-30 |
| Street Address |
641 LATTON LN SUITE A |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-1078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194237123 | Jessica Rose Dredske | Chiropractor | 641 Latton Ln, Portage, WI 53901-1078 | 2017-10-31 |
| 1750610051 | Brian David Heeren | Chiropractor | 641 Latton Ln, Portage, WI 53901-1078 | 2009-12-15 |
| 1003003716 | Blau Chiropractic Sc | Chiropractor | 641 Latton Ln, Portage, WI 53901-1078 | 2007-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975775 | Kalamazoo Chiropractic & Rehabilitation | Chiropractor | 3275 Cooley Ct Ste 150, Portage, MI 49024-7432 | 2020-02-25 |
| 1811548555 | Michael Thomas Martini | Chiropractor | 1930 W Milham Ave Ste D, Portage, MI 49024-2228 | 2019-09-24 |
| 1134634934 | Portage Chiropractic and Wellness Center | Chiropractor | 609 E. Centre, Portage, MI 49002 | 2017-12-04 |
| 1023405016 | Ryan Ball | Chiropractor | 5228 Lovers Ln Ste 110, Portage, MI 49002-1521 | 2015-04-17 |
| 1225434871 | Sarah Malarney | Chiropractor | 3920 W Centre Ave, Portage, MI 49024-4634 | 2014-11-10 |
| 1730429838 | Living Well Chiropractic Center | Chiropractor | 6040 S 12th St, Suite B, Portage, MI 49024-1752 | 2013-02-26 |
| 1245588847 | Community Chiropractic Spine Center | Chiropractor | 6325 Central Avenue, Portage, IN 46368-3801 | 2012-08-29 |
| 1831469865 | Ronald L Warner | Chiropractor | 5919 Portage Rd, Portage, MI 49002-1726 | 2012-01-06 |
| 1528360351 | A Chiro-effect Chiropractic LLC | Chiropractor | 7117 S Westnedge Ave Ste 3, Portage, MI 49002-4201 | 2010-11-30 |
| 1386876944 | Jeffrey Edward Wiederhold | Chiropractor | 7117 S Westnedge Ave, Suite #3, Portage, MI 49002-4201 | 2009-08-17 |
| Find all providers in PORTAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.