NPIMap

Organization Active NPI

McMahon Chiropractic and Physical Therapy Clinic LLC

Doing business as McMahon Chiropractic & Physical Therapy

  • Chiropractor
  • Eau Claire, WI
National Provider Identifier
1265625008
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MCMAHON CHIROPRACTIC AND PHYSICAL THERAPY CLINIC LLC
Doing business as
McMahon Chiropractic & Physical Therapy
Practice address
3004 Golf Rd
Suite 100
Eau Claire, WI 54701-8793
Phone
(715) 834-4516
Fax
(715) 834-0552
NPI assigned
Aug 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Authorized official

Name
Michael J McMahon, DCNPI 1871669697
Title
Owner - Sole Member
Phone
(715) 834-4516

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

3004 Golf Rd
Suite 100
Eau Claire, WI 54701-8793

Mailing address

3004 Golf Rd
Suite 100
Eau Claire, WI 54701-8793
Phone (715) 834-4516

Other identifiers 1

IdentifierTypeStateIssuer
39000900MedicaidWI

Other names 1

  • McMahon Chiropractic & Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190417001193 WI Part B Supplier - Clinic/Group Practice 9739420936 Receives reassigned benefits from 2 practitioners
Practice locations: Eau Claire, WI

National Provider Directory

National Provider Directory

Locations

3004 Golf Rd
Ste 100
Eau Claire, WI 54701
Phone (715) 514-2827

4330 Golf Ter
Ste 107
Eau Claire, WI 54701
Phone (715) 833-4960

Practitioners & affiliated clinicians

Practitioners 8

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": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1265625008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 GOLF RD",
            "address_2": "SUITE 100",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018793",
            "telephone_number": "715-834-4516",
            "fax_number": "715-834-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 GOLF RD",
            "address_2": "SUITE 100",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018793",
            "telephone_number": "715-834-4516",
            "fax_number": "715-834-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCMAHON CHIROPRACTIC AND PHYSICAL THERAPY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER - SOLE MEMBER",
        "authorized_official_telephone_number": "715-834-4516",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39000900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McMahon Chiropractic & Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McMahon Chiropractic & Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.