Individual provider Active NPI

Jennifer Schueler

  • Chiropractor
  • Valrico, FL
National Provider Identifier
1144678616
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12671 Issued in FL
Practice address
4341 Lynx Paw TRL
Valrico, FL 33596
Phone
(813) 409-3304
NPI assigned
May 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5183-12 WI
Chiropractor 111N00000X CH12671 FL Primary

Addresses

Primary practice location

4341 Lynx Paw TRL
Valrico, FL 33596

Mailing address

4341 Lynx Paw TRL
Valrico, FL 33596-7426
Phone (813) 409-3304

Other practice location 1

126 S Main St
Seymour, WI 54165-1475
Phone (920) 833-7844

Other practice location 2

1315 W Mason St
Green Bay, WI 54303-2073
Phone (920) 884-6100

Other practice location 3

4341 Lynx Paw Trl
Valrico, FL 33596
Phone (813) 409-3304

Other identifiers 1

IdentifierTypeStateIssuer
1144678616MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190603001007 FL Practitioner - Chiropractic 7911298765 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12671FLMDChiropractor
5183-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Champion Wellness Centers, Fishhawk, LLC Chiropractor CurrentSince Apr 2, 2019 Accepting new patients
Thornton Chiropractic Center, P.a. Past Accepting new patients

Locations

906 Lithia Pinecrest Rd
Brandon, FL 33511
Phone (813) 409-3304

4341 Lynx Paw Trl
Valrico, FL 33596
Phone (813) 409-3304

Organizations & group practices 2

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": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1144678616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4341 LYNX PAW TRL",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335967426",
            "telephone_number": "813-409-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 LYNX PAW TRL",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "33596",
            "telephone_number": "813-409-3304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 S Main St",
            "address_purpose": "LOCATION",
            "city": "Seymour",
            "state": "WI",
            "postal_code": "541651475",
            "country_code": "US",
            "telephone_number": "920-833-7844",
            "fax_number": "920-833-7946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1315 W Mason St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543032073",
            "country_code": "US",
            "telephone_number": "920-884-6100",
            "fax_number": "920-884-6311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4341 Lynx Paw Trl",
            "address_purpose": "LOCATION",
            "city": "Valrico",
            "state": "FL",
            "postal_code": "33596",
            "country_code": "US",
            "telephone_number": "813-409-3304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUELER",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5183-12",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144678616",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.