Individual provider Active NPI

Loni Marie McClellan, DC

  • Chiropractor
  • Brookfield, WI
National Provider Identifier
1164916748
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6015-12 Issued in WI
Practice address
21150 W Capitol Dr Ste 5
Brookfield, WI 53072-2909
Phone
(414) 482-5282
NPI assigned
Jun 18, 2018
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3125 TN
Chiropractor 111N00000X 6015-12 WI Primary

Addresses

Primary practice location

21150 W Capitol Dr Ste 5
Brookfield, WI 53072-2909

Mailing address

21150 W Capitol Dr Ste 5
Brookfield, WI 53072-2909
Phone (414) 482-5282

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drloni@npchiropractic.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201007000825 TN Practitioner - Chiropractic 4688093669 Reassigns benefits to 1 organization
I20221005000197 WI Practitioner - Chiropractic 4688093669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jaskowiak Chiropractic Office SCGroup PAC ID 5496841058, 5 clinicians

Practice addresses (Care Compare)

N85W15762 Appleton Ave
Menomonee Falls, WI 53051-3043
Phone (262) 255-9636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3125TNMDChiropractor
6015-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Spine Specialists, PLLC Chiropractor CurrentSince Oct 1, 2020 Accepting new patients
A Sound Mind Behavioral Health PastSince Oct 1, 2020 Accepting new patients

Locations

321 Billingsly Ct
Franklin, TN 37067
Phone (615) 445-7600

Organizations & group practices 3

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1164916748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21150 W CAPITOL DR STE 5",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530722909",
            "telephone_number": "414-482-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21150 W CAPITOL DR STE 5",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530722909",
            "telephone_number": "414-482-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "LONI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "3125",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6015-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drloni@npchiropractic.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21150 W Capitol Dr Ste 5",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530722909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.