Detert Chiropractic Office SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2895-012 Issued in WI

Legal business name

DETERT CHIROPRACTIC OFFICE SC

Practice address

1101 N Main St
Marion, WI 54950-9182

Phone

(715) 754-2555

Fax

(715) 754-2559

NPI assigned

Jul 29, 2005

Last updated

Jul 9, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Laura Leanne Detert, DCNPI 1154489425

Title

President Chiropractor

Phone

(715) 754-2555

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

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.

• Laura Leanne Detert, D.C.

  • Chiropractor
  • Marion, WI
  • NPI 1154489425
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1235139353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 485",
            "city": "MARION",
            "state": "WI",
            "postal_code": "549500485",
            "telephone_number": "715-754-2555",
            "fax_number": "715-754-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N MAIN ST",
            "city": "MARION",
            "state": "WI",
            "postal_code": "549509182",
            "telephone_number": "715-754-2555",
            "fax_number": "715-754-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETERT CHIROPRACTIC OFFICE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "DETERT",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "LEANNE",
        "authorized_official_title_or_position": "PRESIDENT CHIROPRACTOR",
        "authorized_official_telephone_number": "715-754-2555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2895-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OFF38984900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAURA38866500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jami Beilfuss, RN
• Laura Leanne Detert, D.C.
• Get Well Health Services LLC
• Christopher P Gilling, DDS
• Erik Steven Gilling, DDS
• Justin Joseph Gilling, DDS

• Chiropractor in Marion, WI
• Providers in Marion, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.