Individual provider Active NPI

Kevin S. Wianecki, D.C.

  • Chiropractor
  • Mosinee, WI
National Provider Identifier
1124056213
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3593-12 Issued in WI
Practice address
2290 County Highway X
Suite B
Mosinee, WI 54455
Phone
(715) 693-3170
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3593-12 WI Primary

Addresses

Primary practice location

2290 County Highway X
Suite B
Mosinee, WI 54455

Mailing address

786 Oak Rd
Mosinee, WI 54455-8044
Phone (715) 693-3170

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3593-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Health of Wisconsin, SC Chiropractor Past Accepting new patients
Mosinee Family Chiropractic SC Chiropractor PastSince Dec 31, 2015 Accepting new patients
Wianecki Chiropractic, L.L.C. PastSince Aug 7, 2006 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124056213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 OAK RD",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544558044",
            "telephone_number": "715-693-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 COUNTY HIGHWAY X",
            "address_2": "SUITE B",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "54455",
            "telephone_number": "715-693-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIANECKI",
        "first_name": "KEVIN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3593-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mosinee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.