Organization Active NPI

Sozo Chiropractic

  • Clinic/Center
  • Kenosha, WI
National Provider Identifier
1144638065
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4455 Issued in WI
Legal business name
SOZO CHIROPRACTIC
Practice address
3720 72ND Ave
Kenosha, WI 53144-7300
Phone
(262) 764-9301
Fax
(262) 764-9303
NPI assigned
Jul 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Authorized official

Name
Dr. Doni Beth Davis, D.C.NPI 1306081658
Title
Owner/ Chiropractor
Phone
(262) 764-9301

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
Clinic/Center 261Q00000X 4455 WI Primary

Addresses

Primary practice location

3720 72ND Ave
Kenosha, WI 53144-7300

Mailing address

3720 72ND Ave
Kenosha, WI 53144-7300
Phone (262) 764-9301

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141013000881 WI Part B Supplier - Clinic/Group Practice 3779703806 Receives reassigned benefits from 1 practitioner
Practice locations: Kenosha, WI

National Provider Directory

National Provider Directory

Locations

1711 Green Bay Rd
Ste C
Kenosha, WI 53144
Phone (262) 764-9301

3720 72nd Ave
Kenosha, WI 53144
Phone (262) 764-9301

Practitioners & affiliated clinicians

Practitioners 3

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": "1406073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1144638065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 72ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531447300",
            "telephone_number": "262-764-9301",
            "fax_number": "262-764-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 72ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531447300",
            "telephone_number": "262-764-9301",
            "fax_number": "262-764-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOZO CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DONI",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER/ CHIROPRACTOR",
        "authorized_official_telephone_number": "262-764-9301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "4455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.