Organization Active NPI

Reeson Chiropractic LLC

  • Chiropractor
  • Cross Plains, WI
National Provider Identifier
1235287582
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4130-012 Issued in WI
Legal business name
REESON CHIROPRACTIC LLC
Practice address
2034 Main St
Suite 4
Cross Plains, WI 53528-8855
Phone
(608) 798-3437
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Authorized official

Name
Dr. Dustin Reeson, D.C.NPI 1780757815
Title
Owner
Phone
(608) 798-3437

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 4130-012 WI Primary

Addresses

Primary practice location

2034 Main St
Suite 4
Cross Plains, WI 53528-8855

Mailing address

3029 Allies LN
Cross Plains, WI 53528-9264
Phone (563) 940-1600

Other identifiers 1

IdentifierTypeStateIssuer
38960900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050421000106 WI Part B Supplier - Clinic/Group Practice 1456399344 Receives reassigned benefits from 1 practitioner
Practice locations: Cross Plains, WI

National Provider Directory

National Provider Directory

Locations

2034 Main St
Ste 4
Cross Plains, WI 53528
Phone (608) 778-3437

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240790400000",
    "number": "1235287582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3029 ALLIES LN",
            "city": "CROSS PLAINS",
            "state": "WI",
            "postal_code": "535289264",
            "telephone_number": "563-940-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 MAIN ST",
            "address_2": "SUITE 4",
            "city": "CROSS PLAINS",
            "state": "WI",
            "postal_code": "535288855",
            "telephone_number": "608-798-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REESON CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2009-04-27",
        "status": "A",
        "authorized_official_last_name": "REESON",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-798-3437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4130-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38960900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cross Plains, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.