Dr. Keith Adam Alexander

Neurology NPI1780893628

Summary

About

Dr. Keith Adam Alexander specialises in Neurology. He currently works in Wisconsin.

Provider Details

NPI Number 1780893628
Provider Name Keith Adam Alexander
Credential
Specialization Neurology
Medical School Name Life Chiropractic College
Graduation Year 1994
Gender M
Entity Type Individual
PAC ID by PECOS 2264619865
Professional Enrollment ID I20110608000348
Enumeration Date 05/21/2007
Last Update Date 05/22/2013

Contact Details

Business Practice address 12719 SHERIDAN RD, Pleasant Prairie,
53158-5336 Wisconsin View on Google Map
Business Practice phone 262-484-4165
Business Practice fax 262-484-4326
Mailing address 12719 SHERIDAN RD, Pleasant Prairie,
53158-5336 Wisconsin View on Google Map
Other phone 262-484-4165
Other fax 262-484-4326
Email Address shannonfig@domain.com Reval Email Address
Incorrect information? Update the NPI Details for Keith Adam Alexander Update NPI

Hospital Affilitation

Practices in Pleasant Prairie

Pleasant Prairie, Wisconsin

Education & Training

Life Chiropractic College

Neurology, 1994

Newsletter for Healthcare Professionals

Provider Taxonomy Details

Provider Taxonomy 1
Grouping name
Taxonomy
License No.
0104001349 (Virginia)
Primary Taxonomy
Grouping name
Taxonomy
License No.
4717-12 (Wisconsin)
Provider Taxonomy 3
Grouping name
Taxonomy
License No.
038.012332 (Illinois)

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1780893628
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor Y
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Alexander
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name Keith
The first name of the provider, if the provider is an individual.
Provider Credential Text DC, DCBCN
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address 12719 SHERIDAN RD
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Pleasant Prairie
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name Wisconsin
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 53158-5336
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 262-484-4165
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider Business Mailing Address Fax Number 262-484-4326
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider First Line Business Practice Location Address 12719 SHERIDAN RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Pleasant Prairie
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name Wisconsin
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 53158-5336
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 262-484-4165
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 262-484-4326
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 05/21/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 05/22/2013
The date that a record was last updated or changed.
Provider Gender Code M
The code designating the provider's gender if the provider is a person.
Provider Gender Male
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 111NN0400X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 Chiropractic Neurology is defined as the field of functional neurology that engages the internal - and external environment of the individual in a structured and targeted approach to affect positive changes in the nervous system and consequently the physiology and behavior of an individual. Chiropractic Neurologists are board-certified specialists in non-drug, non-surgical care for those with neurologically based health problems. There are many conditions people suffer from that are in this broad category: learning and attention disorders, headaches, vertigo, pain syndromes, developmental disorders, nerve injury, spinal cord injury, head injury or stroke, movement disorders, and many other conditions.
Healthcare Provider Taxonomy #1
Provider License Number 1 0104001349
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 VA
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #2 111NN0400X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 2 Chiropractic Neurology is defined as the field of functional neurology that engages the internal - and external environment of the individual in a structured and targeted approach to affect positive changes in the nervous system and consequently the physiology and behavior of an individual. Chiropractic Neurologists are board-certified specialists in non-drug, non-surgical care for those with neurologically based health problems. There are many conditions people suffer from that are in this broad category: learning and attention disorders, headaches, vertigo, pain syndromes, developmental disorders, nerve injury, spinal cord injury, head injury or stroke, movement disorders, and many other conditions.
Healthcare Provider Taxonomy #2
Provider License Number 2 4717-12
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2 WI
Provider License Number State Code #2
Healthcare Provider Primary Taxonomy Switch 2 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #3 111NN0400X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 3 Chiropractic Neurology is defined as the field of functional neurology that engages the internal - and external environment of the individual in a structured and targeted approach to affect positive changes in the nervous system and consequently the physiology and behavior of an individual. Chiropractic Neurologists are board-certified specialists in non-drug, non-surgical care for those with neurologically based health problems. There are many conditions people suffer from that are in this broad category: learning and attention disorders, headaches, vertigo, pain syndromes, developmental disorders, nerve injury, spinal cord injury, head injury or stroke, movement disorders, and many other conditions.
Healthcare Provider Taxonomy #3
Provider License Number 3 038.012332
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 3 IL
Provider License Number State Code #3
Healthcare Provider Primary Taxonomy Switch 3 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.