Organization Active NPI

Breidenbach Family and Sports Chiropractic Inc

  • Chiropractor
  • La Crosse, WI
National Provider Identifier
1003987652
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BREIDENBACH FAMILY AND SPORTS CHIROPRACTIC INC
Practice address
1526 Rose St
La Crosse, WI 54603-4500
Phone
(608) 781-9880
NPI assigned
Nov 13, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Amy Kay Breidenbach, DCNPI 1376644567
Title
Owner/Chiropractor
Phone
(608) 386-9538

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

1526 Rose St
La Crosse, WI 54603-4500

Mailing address

1526 Rose St
La Crosse, WI 54603-4500
Phone (608) 781-9880

Other identifiers 1

IdentifierTypeStateIssuer
38930000MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080123000035 WI Part B Supplier - Clinic/Group Practice 3274614730 Receives reassigned benefits from 5 practitioners
Practice locations: La Crosse, WI; Onalaska, WI

National Provider Directory

National Provider Directory

Locations

1526 Rose St
La Crosse, WI 54603
Phone (608) 317-4644

1526 Rose St
Ste 102
La Crosse, WI 54603
Phone (608) 781-9880

1605 Losey Blvd S
La Crosse, WI 54601
Phone (608) 788-7880

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1003987652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 ROSE ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546034500",
            "telephone_number": "608-781-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 ROSE ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546034500",
            "telephone_number": "608-781-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREIDENBACH FAMILY AND SPORTS CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BREIDENBACH",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "608-386-9538",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38930000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.