Organization Active NPI

Eagle Family Chiropractic

  • Chiropractor
  • Eagle River, WI
National Provider Identifier
1134645682
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5087 Issued in WI
Legal business name
EAGLE FAMILY CHIROPRACTIC
Practice address
701 N Railroad St
Eagle River, WI 54521-8833
Phone
(715) 479-4214
Fax
(715) 477-2770
NPI assigned
Aug 16, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Mark James Bugni, DCNPI 1386053452
Title
Chiropractor
Phone
(715) 479-4214

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 5087 WI Primary

Addresses

Primary practice location

701 N Railroad St
Eagle River, WI 54521-8833

Mailing address

701 N Railroad St
Eagle River, WI 54521-8833
Phone (715) 479-4214

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170916000505 WI Part B Supplier - Clinic/Group Practice 8820362783 Receives reassigned benefits from 1 practitioner
Practice locations: Eagle River, WI

National Provider Directory

National Provider Directory

Locations

701 N Railroad St
Eagle River, WI 54521
Phone (715) 479-4214

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1134645682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N RAILROAD ST",
            "city": "EAGLE RIVER",
            "state": "WI",
            "postal_code": "545218833",
            "telephone_number": "715-479-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N RAILROAD ST",
            "city": "EAGLE RIVER",
            "state": "WI",
            "postal_code": "545218833",
            "telephone_number": "715-479-4214",
            "fax_number": "715-477-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BUGNI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "715-479-4214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.