Organization Active NPI

Alexander Chiropractic Neurology Center, LLC

  • Neurology Chiropractor
  • Kenosha, WI
National Provider Identifier
1255677340
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
4717-12 Issued in WI
Legal business name
ALEXANDER CHIROPRACTIC NEUROLOGY CENTER, LLC
Practice address
2717 18TH St Ste 100
Kenosha, WI 53140-4666
Phone
(262) 484-4165
Fax
(262) 484-4326
NPI assigned
Dec 18, 2012
Last updated
Jun 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Dr. Keith Adam Alexander, DC, DCBCNNPI 1780893628
Title
Owner/President
Phone
(262) 484-4165

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
Neurology Chiropractor 111NN0400X 4717-12 WI Primary

Addresses

Primary practice location

2717 18TH St Ste 100
Kenosha, WI 53140-4666

Mailing address

2717 18TH St Ste 100
Kenosha, WI 53140-4666
Phone (262) 484-4165

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130322000146 WI Part B Supplier - Clinic/Group Practice 4183869191 Receives reassigned benefits from 1 practitioner
Practice locations: Kenosha, WI

National Provider Directory

National Provider Directory

Locations

2717 18th St
Ste 100
Kenosha, WI 53140
Phone (262) 551-5650

12719 Sheridan Rd
Pleasant Prairie, WI 53158
Phone (262) 484-4165

Practitioners & affiliated clinicians

Practitioners 1

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": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1255677340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 18TH ST STE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404666",
            "telephone_number": "262-484-4165",
            "fax_number": "262-484-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 18TH ST STE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404666",
            "telephone_number": "262-484-4165",
            "fax_number": "262-484-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDER CHIROPRACTIC NEUROLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "262-484-4165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, DCBCN"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "WI",
            "license": "4717-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.