Individual provider Active NPI

Madalyn M Kornowski, DC

  • Chiropractor
  • Hortonville, WI
National Provider Identifier
1104658657
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6203-12 Issued in WI
Practice address
N815 Brookview Dr
Hortonville, WI 54944-9277
Phone
(920) 659-2794
NPI assigned
Aug 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6203-12 WI Primary

Addresses

Primary practice location

N815 Brookview Dr
Hortonville, WI 54944-9277

Mailing address

2521 E Washington Ave Apt 410
Madison, WI 53704-5278
Phone (920) 659-2794

Other names 1

  • Madalyn Walter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6203-12WIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1104658657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 E WASHINGTON AVE APT 410",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537045278",
            "telephone_number": "920-659-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N815 BROOKVIEW DR",
            "city": "HORTONVILLE",
            "state": "WI",
            "postal_code": "549449277",
            "telephone_number": "920-659-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNOWSKI",
        "first_name": "MADALYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6203-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADALYN",
            "last_name": "WALTER",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hortonville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.