Individual provider Active NPI

Zachary Landon, D.C.

  • Sports Physician Chiropractor
  • Reedsburg, WI
National Provider Identifier
1063779312
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
4873-12 Issued in WI
Practice address
158 E Main St
Ste 1a
Reedsburg, WI 53959-1972
Phone
(608) 415-0705
NPI assigned
Apr 11, 2012
Last updated
Jan 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 4873-12 WI Primary

Addresses

Primary practice location

158 E Main St
Ste 1a
Reedsburg, WI 53959-1972

Mailing address

158 E Main St
Ste 1a
Reedsburg, WI 53959-1972
Phone (608) 415-0705

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120619000254 WI Practitioner - ChiropracticPractitioner - Sports MedicinePractitioner - Physical Medicine and Rehabilitation 0446414668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Landon Chiropractic LLCGroup PAC ID 1153663745, 2 clinicians

Practice addresses (Care Compare)

158 E Main St
Suite 1a
Reedsburg, WI 53959-1972
Phone (608) 415-0705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Landon Chiropractic, LLC CurrentSince Feb 19, 2019 Accepting new patients

Locations

158 E Main St
Ste 1A
Reedsburg, WI 53959
Phone (608) 415-0705

158 E Main St
Unit 1A
Reedsburg, WI 53959
Phone (608) 415-0705

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1063779312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 E MAIN ST",
            "address_2": "STE 1A",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591972",
            "telephone_number": "608-415-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 E MAIN ST",
            "address_2": "STE 1A",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591972",
            "telephone_number": "608-415-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDON",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WI",
            "license": "4873-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedsburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.