Individual provider Active NPI

Amy Gamerdinger Jeffers, D.C.

  • Chiropractor
  • Chippewa Falls, WI
National Provider Identifier
1194973644
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4436-012 Issued in WI
Practice address
2889 County Highway I
Suite 2
Chippewa Falls, WI 54729-4300
Phone
(715) 720-2887
Fax
(715) 720-2304
NPI assigned
Sep 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4436-012 WI Primary

Addresses

Primary practice location

2889 County Highway I
Suite 2
Chippewa Falls, WI 54729-4300

Mailing address

107 N Bridge St
Chippewa Falls, WI 54729-2404
Phone (715) 720-2887

Other identifiers 1

IdentifierTypeStateIssuer
38188000MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081028000010 WI Practitioner - Chiropractic 0547328361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

107 N Bridge St
Chippewa Falls, WI 54729-2404
Phone (715) 720-2887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4436-012WIMDChiropractor
4436WIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Wissota Family Chiropractic Chiropractor CurrentSince Oct 1, 2008 Accepting new patients

Locations

2889 County Highway I
Ste 2
Chippewa Falls, WI 54729
Phone (715) 404-9716

107 N Bridge St
Chippewa Fls, WI 54729
Phone (715) 226-5807

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1194973644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N BRIDGE ST",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547292404",
            "telephone_number": "715-720-2887",
            "fax_number": "715-720-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2889 COUNTY HIGHWAY I",
            "address_2": "SUITE 2",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547294300",
            "telephone_number": "715-720-2887",
            "fax_number": "715-720-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMERDINGER JEFFERS",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4436-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38188000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.