NPIMap

Organization Active NPI

Pediatric, Prenatal and Family Chiropractic of Wisconsin LLC

  • Chiropractor
  • Mount Pleasant, WI
National Provider Identifier
1164094975
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PEDIATRIC, PRENATAL AND FAMILY CHIROPRACTIC OF WISCONSIN LLC
Practice address
1524 S Green Bay Rd Ste 101
Mount Pleasant, WI 53406-5788
Phone
(262) 800-1115
NPI assigned
Jul 12, 2021
Last updated
Jun 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Authorized official

Name
Holly GeorgesonNPI 1043675549
Title
Owner
Phone
(262) 800-1115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1524 S Green Bay Rd Ste 101
Mount Pleasant, WI 53406-5788

Mailing address

1524 S Green Bay Rd Ste 101
Mount Pleasant, WI 53406-5788

National Provider Directory

National Provider Directory

Locations

1524 S Green Bay Rd
Ste 101
Mount Pleasant, WI 53406
Phone (262) 800-1115

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": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1164094975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 S GREEN BAY RD STE 101",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 S GREEN BAY RD STE 101",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065788",
            "telephone_number": "262-800-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC, PRENATAL AND FAMILY CHIROPRACTIC OF WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "GEORGESON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-800-1115"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.