Organization Active NPI

Chiro One Wellness Center of Sun Prairie LLC

  • Chiropractor
  • Sun Prairie, WI
National Provider Identifier
1124740246
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIRO ONE WELLNESS CENTER OF SUN PRAIRIE LLC
Practice address
695 S Grand Ave Ste 103
Sun Prairie, WI 53590-9722
Phone
(608) 688-0911
NPI assigned
Sep 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Matthew Frahm, DCNPI 1801060819
Title
DC
Phone
(630) 229-4430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

695 S Grand Ave Ste 103
Sun Prairie, WI 53590-9722

Mailing address

PO Box 74008519 PMB 1352
Chicago, IL 60674-0001
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221205001096 WI Part B Supplier - Clinic/Group Practice 7618346289 Receives reassigned benefits from 3 practitioners
Practice locations: Sun Prairie, WI

National Provider Directory

National Provider Directory

Locations

695 S Grand Ave
Ste 103
Sun Prairie, WI 53590
Phone (608) 688-0911

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1124740246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74008519 PMB 1352",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740001",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 S GRAND AVE STE 103",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535909722",
            "telephone_number": "608-688-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF SUN PRAIRIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "FRAHM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DC",
        "authorized_official_telephone_number": "630-229-4430",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.