Active NPI
Gerald Richard Kennedy Jr., DC
- Chiropractor
- Oostburg, WI
National Provider Identifier
1154313344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2099012
- Practice address
- 28 N 10TH St
Oostburg, WI 53070-1181 - Phone
- (920) 564-6653
- NPI assigned
- Aug 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2099012 | WI | Primary |
Addresses
Primary practice location
28 N 10TH St
Oostburg, WI 53070-1181
Mailing address
28 N 10TH St
Oostburg, WI 53070-1181
Phone (920) 564-6653
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2099012 | WI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1154313344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 N 10TH ST",
"city": "OOSTBURG",
"state": "WI",
"postal_code": "530701181",
"telephone_number": "920-564-6653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 N 10TH ST",
"city": "OOSTBURG",
"state": "WI",
"postal_code": "530701181",
"telephone_number": "920-564-6653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "GERALD",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "2099012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oostburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.