Organization Active NPI

Barge Chiropractic Family & Wellness Clinic, LLC

  • Chiropractor
  • Holmen, WI
National Provider Identifier
1245578855
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2624 Issued in WI
Legal business name
BARGE CHIROPRACTIC FAMILY & WELLNESS CLINIC, LLC
Practice address
3812 Creekside LN
Holmen, WI 54636-9466
Phone
(608) 781-9777
Fax
(608) 781-9747
NPI assigned
Jan 17, 2013
Last updated
Jan 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Authorized official

Name
Felicia Olson
Title
Insurance Clerk
Phone
(608) 781-9777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2624 WI Primary

Addresses

Primary practice location

3812 Creekside LN
Holmen, WI 54636-9466

Mailing address

3812 Creekside LN
Holmen, WI 54636-9466
Phone (608) 781-9777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130220000253 WI Part B Supplier - Clinic/Group Practice 9335394519 Receives reassigned benefits from 4 practitioners
Practice locations: Holmen, WI

National Provider Directory

National Provider Directory

Locations

3812 Creekside Ln
Holmen, WI 54636
Phone (507) 452-0994

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1245578855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 CREEKSIDE LN",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "546369466",
            "telephone_number": "608-781-9777",
            "fax_number": "608-781-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 CREEKSIDE LN",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "546369466",
            "telephone_number": "608-781-9777",
            "fax_number": "608-781-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARGE CHIROPRACTIC FAMILY & WELLNESS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_title_or_position": "INSURANCE CLERK",
        "authorized_official_telephone_number": "608-781-9777"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmen, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.