Individual provider Active NPI

Jan W Cecka, D.C

  • Chiropractor
  • Plymouth, WI
National Provider Identifier
1235237603
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2629-012 Issued in WI
Practice address
126 E Mill St
Plymouth, WI 53073-1704
Phone
(920) 892-8920
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2629-012 WI Primary

Addresses

Primary practice location

126 E Mill St
Plymouth, WI 53073-1704

Mailing address

126 E Mill St
Plymouth, WI 53073-1704
Phone (920) 892-8920

Other identifiers 1

IdentifierTypeStateIssuer
38852600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2629-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sheboygan Chiro Plus LLC Chiropractor CurrentSince Mar 1, 2022 Accepting new patients

Locations

126 E Mill St
Plymouth, WI 53073
Phone (920) 892-8920

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1235237603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E MILL ST",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530731704",
            "telephone_number": "920-892-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E MILL ST",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530731704",
            "telephone_number": "920-892-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECKA",
        "first_name": "JAN",
        "middle_name": "W",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2629-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38852600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.