Breidenbach Family and Sports Chiropractic Inc
Organization Active NPI Chiropractor · La Crosse, WI
NPI 1003987652 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1003987652
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 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
- Organization subpart
- No
Authorized official
- Name
- Dr. Amy Kay Breidenbach, DC
- Title
- Owner/Chiropractor
- Phone
- (608) 386-9538
Practitioners 25
-
Ashley Gravelle, DC
-
Amy Kay Breidenbach, DC DICCP
-
Ross Mundinger, DC
-
Sarah Coffey, PA-C
-
Jilayne Karr, NP
-
Lori Ann Miskell, NP
-
Mary Ellen Stolder, NURSE PRACTITIONER
-
Amy Todd, NP
-
Victor Benson, D.C.
-
Jeffrey F Menn, M.D.
-
Jade Altman Mikshowsky, DNP, APRN
-
Marissa Pederson, DNP, APNP, FNP-C
-
Katie R Stewart, P.A.C.
-
Tena M. Thompson, D.C.
-
Mandy J Vannatta, D.C.
-
Kristin Ann Buege, D.C.
-
Jesse C. Ploessl, D.C.
-
Alyssa Ann Race, DNP, APRN, FNP-C
-
Abby Kathleen Rose, D.C.
-
Rick White, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38930000 | Medicaid | WI |
Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.