Organization Active NPI

McGinnis Chiropractic Health Clinic

  • Occupational Health Chiropractor
  • Winneconne, WI
National Provider Identifier
1265148142
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
Legal business name
MCGINNIS CHIROPRACTIC HEALTH CLINIC
Practice address
11 N 6TH Ave
Winneconne, WI 54986-9705
Phone
(920) 850-5448
Fax
(920) 582-4004
NPI assigned
Jan 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Authorized official

Name
Dr. Samuel John Edward McGinnis, D.C.NPI 1346708351
Title
Owner
Phone
(920) 850-5448

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
Occupational Health ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0100X Primary

Addresses

Primary practice location

11 N 6TH Ave
Winneconne, WI 54986-9705

Mailing address

11 N 6TH Ave
Winneconne, WI 54986-9705
Phone (920) 850-5448

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230407001843 WI Part B Supplier - Clinic/Group Practice 3678948437 Receives reassigned benefits from 2 practitioners
Practice locations: Winneconne, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1265148142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 N 6TH AVE",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "549869705",
            "telephone_number": "920-850-5448",
            "fax_number": "920-582-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 N 6TH AVE",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "549869705",
            "telephone_number": "920-850-5448",
            "fax_number": "920-582-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCGINNIS CHIROPRACTIC HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "MCGINNIS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "JOHN EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-850-5448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Occupational Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winneconne, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.