CMS-1500 Box 24J / 33a • NPI
1720046428
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
111NS0005X (CMS 35)
Licensed & Credentialed Chiropractic Providers — Chiropractor, Sports Physician
Box 32 Service Location & ZIP+4
617 MAIN ST, COLFAX, WI, 54730-9148
✓ 9-Digit EDI 837 ZIP+4 (54730-9148)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1720046428 (GEORGE WILLIAM BERRES, D.C.,C.C.S.P.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1720046428 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | GEORGE WILLIAM BERRES, D.C.,C.C.S.P. |
| Plain-English Specialty | Licensed & Credentialed Chiropractic Providers — Chiropractor, Sports Physician NUCC Code: 111NS0005X (Chiropractor, Sports Physician) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 617 MAIN ST, COLFAX, WI, 54730-9148 |
| Practice Telephone / Fax | Tel: (715) 962-3225 | Fax: (715) 962-3225 |
| Administrative Mailing Address | PO BOX 265, COLFAX, WI, 54730-0265 |
| Enumeration & Last Sync | Enumerated: 2006-05-02 | CMS Record Updated: 2026-07-13 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (111NS0005X)
What Does Taxonomy Code 111NS0005X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111NS0005X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor, Sports Physician"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (GEORGE WILLIAM BERRES, D.C.,C.C.S.P.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
111NS0005X — Chiropractor, Sports PhysicianPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor, Sports Physician | State: WI | License: 2087 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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