Jaclyn Wisniewski, DC

Primary specialty

Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X

License

2021029279 Issued in MO

Practice address

5108 N 22ND St
Ozark, MO 65721-7637

Phone

(501) 339-7267

NPI assigned

Sep 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1235800228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 S WELLER AVE APT A303",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658045274",
            "telephone_number": "501-339-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 N 22ND ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657217637",
            "telephone_number": "501-339-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "JACLYN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "MO",
            "license": "2021029279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenzie Wilcox
• William R Chism OD PC
• Rick W. Williams, MD
• Willow Health Care Inc
• Willow Health Care Inc Dba Riverview Place
• Hailey Wood, PA-C
• McKenzie Elle Wylie, DO
• Merrie Yates, MS CCC-SLP
• Alexis Christine Zahn, PA

• Independent Medical Examiner Chiropractor in Ozark, MO
• Providers in Ozark, MO by specialty
• Independent Medical Examiner Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.