Scott Thomas Suprenand, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4745-12 Issued in WI

Practice address

103 S Pioneer Rd Ste 200
Fond Du Lac, WI 54935-3800

Phone

(920) 872-2969

Fax

(920) 933-2511

NPI assigned

Mar 30, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fond Du Lac Family Chiropractic LLCGroup PAC ID 9032466552, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fond Du Lac Family Chiropractic LLC

  • Chiropractor
  • Fond Du Lac, WI
  • NPI 1790278695
  Medicare reassignment Care Compare group NPD Authorized official
• Luedtke-Storm-Mackey Chiropractic Clinic SC

  • Chiropractor
  • Sun Prairie, WI
  • NPI 1457343246
  NPD (past)

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1083903090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S PIONEER RD STE 200",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353800",
            "telephone_number": "920-872-2969",
            "fax_number": "920-933-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S PIONEER RD STE 200",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353800",
            "telephone_number": "920-872-2969",
            "fax_number": "920-933-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPRENAND",
        "first_name": "SCOTT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-30",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4745-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noelle Stroobants, DPT
• Nicole K Stuckart, PA
• Billie A Sturgeon, NP
• Randolph Stutz
• Laura R Suprenand, APNP
• Gabriel J Surges, CAA
• Paula C Svasta, MD
• Paul J. Svoboda, DDS,MSD
• Annmarie E Swanson, APNP
• Wilhelmina Swanson, OTR

• Chiropractor in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.