Johnson Chiropractic, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3987012 Issued in WI

Legal business name

JOHNSON CHIROPRACTIC, INC

Practice address

4435 Mormon Coulee Rd
La Crosse, WI 54601-8220

Phone

(608) 788-4435

Fax

(608) 788-4436

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Lee Johnson, D.C.NPI 1003907817

Title

Owner

Phone

(608) 788-4435

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry Lee Johnson, D.C.

  • Chiropractor
  • La Crosse, WI
  • NPI 1003907817
  Medicare reassignment NPD Authorized official
• Beau J Ellsworth, D.C.

  • Chiropractor
  • Park Ridge, IL
  • NPI 1740388263
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1043332232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 MORMON COULEE RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018220",
            "telephone_number": "608-788-4435",
            "fax_number": "608-788-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 MORMON COULEE RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018220",
            "telephone_number": "608-788-4435",
            "fax_number": "608-788-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-788-4435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3987012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38949300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Hollow, Rd LD
• Gopi Kiran Johanningmeier, C-AA
• John H Betz DDS SC
• John Shea D.D.S. LLC
• John W. Moore DDS, SC
• Johnson Counseling and Consulting
• Barbara Jean Johnson-Hamamoto, RN
• Leanne J Johnson-Meeter, PA
• Pamela J Johnson-Stuhr, PT
• Darcey Lynn Johnson-Timmerman, BSW

• Chiropractor in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.