Individual provider Active NPI

Mandy J Vannatta, D.C.

  • Chiropractor
  • Platteville, WI
National Provider Identifier
1114213279
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4756-012 Issued in WI
Practice address
1250 Business US-151
Ste H
Platteville, WI 53818-9269
Phone
(608) 732-5545
NPI assigned
Jun 27, 2011
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4756-012 WI Primary

Addresses

Primary practice location

1250 Business US-151
Ste H
Platteville, WI 53818-9269

Mailing address

430 E Main St
Platteville, WI 53818-2833
Phone (608) 732-5545

Other names 1

  • Mandy Lund Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110708000228 WI Practitioner - Chiropractic 0648458943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1250 E Business Hwy 151
Suite H
Platteville, WI 53818-3875
Phone (608) 732-5545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4756-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vannatta Chiropractic Chiropractor CurrentSince Sep 27, 2023 Accepting new patients
Breidenbach Family and Sports Chiropractic Inc Chiropractor PastSince Jan 1, 2003 Accepting new patients
Lund Family Chiropractic, Inc. Chiropractor PastSince Aug 13, 2007 Accepting new patients
Back to Health Chiropractic LLC Chiropractor Past Accepting new patients

Locations

1250 E Business Highway 151
Ste H
Platteville, WI 53818
Phone (608) 348-6600

Organizations & group practices 4

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1114213279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E MAIN ST",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538182833",
            "telephone_number": "608-732-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BUSINESS US-151",
            "address_2": "STE H",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538189269",
            "telephone_number": "608-732-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNATTA",
        "first_name": "MANDY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4756-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "LUND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Platteville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.