Individual provider Active NPI

Jason L Guerin, DC

  • Chiropractor
  • Stoughton, WI
National Provider Identifier
1053425348
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3683012 Issued in WI
Practice address
798 Hwy 51 East
Stoughton, WI 53589
Phone
(608) 873-8113
Fax
(608) 873-7533
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3683012 WI Primary

Addresses

Primary practice location

798 Hwy 51 East
Stoughton, WI 53589

Mailing address

PO Box 339
798 Hwy 51 East
Stoughton, WI 53589
Phone (608) 873-8113

Other identifiers 1

IdentifierTypeStateIssuer
38933800MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100923000147 WI Practitioner - Chiropractic 6305962739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zelm Chiropractic Center SCGroup PAC ID 1153426523, 6 clinicians

Practice addresses (Care Compare)

798 Hwy 51 E
Stoughton, WI 53589
Phone (608) 873-8113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3683012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Zelm Chiropractic Center SC Chiropractor CurrentSince Feb 25, 2003 Accepting new patients
Quick Fix After Hours Chiropractic Care, LLC Past Accepting new patients

Locations

4861 Larson Beach Rd
McFarland, WI 53558
Phone (608) 838-7723

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1053425348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "address_2": "798 HWY 51 EAST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "53589",
            "telephone_number": "608-873-8113",
            "fax_number": "608-873-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 HWY 51 EAST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "53589",
            "telephone_number": "608-873-8113",
            "fax_number": "608-873-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERIN",
        "first_name": "JASON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3683012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38933800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.