Organization Active NPI

Mahalko Family Chiropractic LLC

  • Chiropractor
  • Germantown, WI
National Provider Identifier
1174551816
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MAHALKO FAMILY CHIROPRACTIC LLC
Practice address
N112W15237 Mequon Rd
Suite 200
Germantown, WI 53022-3451
Phone
(262) 255-7515
Fax
(262) 255-7513
NPI assigned
Jun 29, 2006
Last updated
Jun 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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

Authorized official

Name
Dr. Ben R Mahalko, DCNPI 1447205943
Title
Co-Owner/Doctor of Chiropractic
Phone
(262) 255-7515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

N112W15237 Mequon Rd
Suite 200
Germantown, WI 53022-3451

Mailing address

N112W15237 Mequon Rd
Suite 200
Germantown, WI 53022-3451
Phone (262) 255-7515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060712000248 WI Part B Supplier - Clinic/Group Practice 0648283739 Receives reassigned benefits from 1 practitioner
Practice locations: Germantown, WI

National Provider Directory

National Provider Directory

Locations

N112W15237 Mequon Rd
Ste 200
Germantown, WI 53022
Phone (262) 255-7515

Practitioners & affiliated clinicians

Practitioners 2

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1174551816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N112W15237 MEQUON RD",
            "address_2": "SUITE 200",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530223451",
            "telephone_number": "262-255-7515",
            "fax_number": "262-255-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N112W15237 MEQUON RD",
            "address_2": "SUITE 200",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530223451",
            "telephone_number": "262-255-7515",
            "fax_number": "262-255-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHALKO FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "MAHALKO",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CO-OWNER/DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "262-255-7515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; 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.