CARLI MARIE VANGOETHEM DC
NPI 1306583687
Chiropractor in Kewaunee, WI
About Carli Marie Vangoethem Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CARLI MARIE VANGOETHEM DC (NPI 1306583687) is an individual chiropractor in Kewaunee, Wisconsin, licensed in Wisconsin (5778-12) and active in the NPI registry since May 2022. She maintains a secondary practice location in Des Moines.
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Carli Marie Vangoethem Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Carli Vangoethem reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Kewaunee, WI 54216
- Reassigned Medicare billing, Wisconsin enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Carli Vangoethem's NPI number?
The NPI number for Carli Vangoethem is 1306583687. It was assigned to this individual provider in the NPPES registry on May 17, 2022.
Where is Carli Vangoethem located?
Carli Vangoethem practices at 402 Ellis St, Kewaunee, WI 54216. The listed phone number is (920) 388-4499.
What is Carli Vangoethem's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Carli Vangoethem enrolled in Medicare?
Yes. Carli Vangoethem is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Carli Vangoethem's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Carli Vangoethem reassigns Medicare benefits to Root Of Wellness Chiropractic LLC (Kewaunee, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carli Vangoethem's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Carli Vangoethem was last updated on March 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Carli Marie Vangoethem, DC · NPI 1306583687
Chiropractor provider in Kewaunee, Wisconsin. Individual provider, active in the CMS NPPES registry since May 17, 2022.
## Identity
- **NPI:** 1306583687 (Entity type: Individual)
- **Enumerated:** May 17, 2022
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** 5778-12 (Wisconsin)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 402 ELLIS ST, Kewaunee, WI 54216-1329
- **Phone:** (920) 388-4499
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Root Of Wellness Chiropractic LLC (NPI 1972290500, Kewaunee, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 15, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1306583687) · Data from the CMS NPPES public registry.