Organization Active NPI

Back-in-Action Chiropractic

  • Chiropractor
  • La Crosse, WI
National Provider Identifier
1235327180
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3804 Issued in WI
Legal business name
BACK-IN-ACTION CHIROPRACTIC
Practice address
300 2ND St N Ste 220
La Crosse, WI 54601
Phone
(262) 492-1626
NPI assigned
Oct 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Authorized official

Name
Dr. Andrew Gary Bakken, DCNPI 1083714679
Title
Owner
Phone
(262) 492-1626

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 3804 WI Primary

Addresses

Primary practice location

300 2ND St N Ste 220
La Crosse, WI 54601

Mailing address

300 2ND St N Ste 220
La Crosse, WI 54601-2001
Phone (608) 782-7738

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121220000019 WI Part B Supplier - Clinic/Group Practice 1153573175 Receives reassigned benefits from 1 practitioner
Practice locations: La Crosse, WI

National Provider Directory

National Provider Directory

Locations

300 2nd St N
Ste 220
La Crosse, WI 54601
Phone (262) 492-1626

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": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1235327180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 2ND ST N STE 220",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546012001",
            "telephone_number": "608-782-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND ST N STE 220",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "54601",
            "telephone_number": "262-492-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK-IN-ACTION CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "BAKKEN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-492-1626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.