Organization Active NPI

Motus Chiropractic & Spine Rehab SC

  • Rehabilitation Chiropractor
  • Milwaukee, WI
National Provider Identifier
1205347564
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
3825-012 Issued in WI
Legal business name
MOTUS CHIROPRACTIC & SPINE REHAB SC
Practice address
5261 N Portwashington Rd
Milwaukee, WI 53217-5321
Phone
(414) 967-9000
Fax
(414) 332-3712
NPI assigned
Oct 13, 2017
Last updated
Jun 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Wendy Kirk
Title
Credentialing Specialist
Phone
(414) 967-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 3825-012 WI Primary

Addresses

Primary practice location

5261 N Portwashington Rd
Milwaukee, WI 53217-5321

Mailing address

PO Box 170181
Milwaukee, WI 53217-8016
Phone (414) 967-9000

Other practice location 1

5261 N Portwashington Rd
Milwaukee, WI 53217-5321
Phone (414) 967-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180131002972 WI Part B Supplier - Clinic/Group Practice 0143580639 Receives reassigned benefits from 3 practitioners
Practice locations: Glendale, WI; Mount Pleasant, WI

National Provider Directory

National Provider Directory

Locations

N4W22370 Bluemound Rd
Ste 202
Waukesha, WI 53186
Phone (262) 521-1954

Practitioners & affiliated clinicians

Practitioners 3

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": "1507852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1205347564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170181",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532178016",
            "telephone_number": "414-967-9000",
            "fax_number": "414-332-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 N PORTWASHINGTON RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532175321",
            "telephone_number": "414-967-9000",
            "fax_number": "414-332-3712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5261 N Portwashington Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532175321",
            "country_code": "US",
            "telephone_number": "414-967-9000",
            "fax_number": "414-332-3712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOTUS CHIROPRACTIC & SPINE REHAB SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-13",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "414-967-9000"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WI",
            "license": "3825-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.