Individual provider Active NPI

Brooke Amber Huettner, D.C.

  • Chiropractor
  • Sparta, WI
National Provider Identifier
1003852724
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4156-012 Issued in WI
Practice address
415 W Wisconsin St Ste 4
Sparta, WI 54656-2493
Phone
(608) 269-4511
Fax
(608) 269-8511
NPI assigned
Jun 21, 2006
Last updated
Jun 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4156-012 WI Primary

Addresses

Primary practice location

415 W Wisconsin St Ste 4
Sparta, WI 54656-2493

Mailing address

415 W Wisconsin St Ste 4
Sparta, WI 54656-2493
Phone (608) 269-4511

Other identifiers 3

IdentifierTypeStateIssuer
38964000MedicaidWI
38984600OtherWIMEDICAID GROUP
391794159330OtherANTHEMBCBS

Other names 1

  • Brooke Amber Davidson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060104000960 WI Practitioner - Chiropractic 2961425947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic Place LLCGroup PAC ID 0345461372, 6 clinicians

Practice addresses (Care Compare)

415 W Wisconsin St
Suite 4
Sparta, WI 54656-2493
Phone (608) 269-4511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4156-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Place LLC Chiropractor CurrentSince Nov 1, 2014 Accepting new patients
Allied Health of Wisconsin, SC Chiropractor PastSince Nov 1, 2014 Accepting new patients

Locations

415 W Wisconsin St
Ste 4
Sparta, WI 54656
Phone (608) 269-4511

Networks

  • IL PPO Downstate
  • IL HMO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1003852724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W WISCONSIN ST STE 4",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546562493",
            "telephone_number": "608-269-4511",
            "fax_number": "608-269-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W WISCONSIN ST STE 4",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546562493",
            "telephone_number": "608-269-4511",
            "fax_number": "608-269-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUETTNER",
        "first_name": "BROOKE",
        "middle_name": "AMBER",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4156-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38964000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "38984600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEMBCBS",
            "identifier": "391794159330",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "DAVIDSON",
            "middle_name": "AMBER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sparta, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.