Organization Active NPI

Keehn Chiropractic Office, S.C.

  • Chiropractor
  • Janesville, WI
National Provider Identifier
1164608246
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KEEHN CHIROPRACTIC OFFICE, S.C.
Practice address
1621 Plainfield Ave
Janesville, WI 53545-0282
Phone
(608) 755-1035
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Authorized official

Name
Stacey L Jordan
Title
Clinic Director
Phone
(608) 755-1035

Specialties & licenses 1

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

Addresses

Primary practice location

1621 Plainfield Ave
Janesville, WI 53545-0282

Mailing address

1621 Plainfield Ave
Janesville, WI 53545-0282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080307000062 WI Part B Supplier - Clinic/Group Practice 7315022969 Receives reassigned benefits from 3 practitioners
Practice locations: Janesville, WI; Evansville, WI

National Provider Directory

National Provider Directory

Locations

2707 Kennedy Rd
Ste 202
Janesville, WI 53545
Phone (608) 755-1035

1621 Plainfield Ave
Janesville, WI 53545
Phone (608) 755-1035

2525 Milton Ave
Ste 213
Janesville, WI 53545
Phone (608) 755-1035

Practitioners & affiliated clinicians

Practitioners 6

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": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1164608246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 PLAINFIELD AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 PLAINFIELD AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450282",
            "telephone_number": "608-755-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEEHN CHIROPRACTIC OFFICE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "608-755-1035"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.