Mark S Edinger, DC
Individual provider Active NPI Orthopedic Chiropractor · Ripon, WI
NPI 1063483048 · NPPES record last updated Mar 7, 2011
Key facts
- NPI
- 1063483048
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Chiropractor 111NX0800X
- License
- 3441 (WI)
- Practice address
- 404 Eureka St
Ripon, WI 54971-1192 - Phone
- (920) 748-3644
- Fax
- (920) 748-3642
- NPI assigned
- Jan 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Yeomans Edinger Chiropractic Center SC
Practice addresses (Care Compare)
404 Eureka St
Ripon, WI 54971-1192
Phone (920) 748-3644
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100929000029 | WI | Practitioner - Chiropractic | 8628125788 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yeomans Edinger Chiropractic Center SC | Current |
Accepting new patients |
Locations
404 Eureka St
Ripon, WI 54971
Phone (414) 748-3644
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Chiropractor | 111NX0800X | 3441 | WI | Yes |
Addresses
Primary practice location
404 Eureka St
Ripon, WI 54971-1192
Mailing address
404 Eureka St
Ripon, WI 54971-1192
Phone (920) 748-3644
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38901800 | Medicaid | WI | |
| 391431452013 | Other | WI | BLUE CROSS |
Other providers in Ripon, WI
- Jessica L Davis
- Eric Demshar
- Glenn F. Devries
- Diverse Options, Inc.
- David N Duehring
- Melissa Anne Edinger
- Stephan W. Eiler
- Elite Senior Living - Fountain View, LLC
- Patricia Jane Ellis
- Empower Mental Health Counseling & Consulting, S.C.
All providers in Ripon, WI · Orthopedic Chiropractor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2011. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.