Individual provider Active NPI

Jordan Teunissen, D.C.

  • Chiropractor
  • Sheboygan, WI
National Provider Identifier
1265984611
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5221-12 Issued in WI
Practice address
2217 S Memorial PL
Sheboygan, WI 53081-3715
Phone
(920) 208-7000
Fax
(920) 600-0257
NPI assigned
Nov 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5221-12 WI Primary

Addresses

Primary practice location

2217 S Memorial PL
Sheboygan, WI 53081-3715

Mailing address

2217 S Memorial PL
Sheboygan, WI 53081-3715
Phone (920) 208-7000

Other practice location 1

126 E Mill St
Plymouth, WI 53073-1704
Phone (920) 892-8920

Other identifiers 1

IdentifierTypeStateIssuer
1265984611MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161111001323 WI Practitioner - Chiropractic 8921387085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2217 S Memorial PL
Sheboygan, WI 53081-3715
Phone (920) 208-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5221-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Audiology & Hearing Center, LLC CurrentSince Jun 26, 2020 Accepting new patients
Plymouth Chiropractic, SC Chiropractor CurrentSince Mar 1, 2022 Accepting new patients
Sheboygan Chiro Plus LLC Chiropractor CurrentSince Jan 1, 2022 Accepting new patients

Locations

4818 S 76th St
Ste 12
Milwaukee, WI 53220
Phone (414) 281-8300

126 E Mill St
Plymouth, WI 53073
Phone (920) 892-8920

1028B Indiana Ave
Sheboygan, WI 53081
Phone (920) 208-7000

2217 S Memorial Pl
Sheboygan, WI 53081
Phone (920) 208-7000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1265984611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 S MEMORIAL PL",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813715",
            "telephone_number": "920-208-7000",
            "fax_number": "920-600-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 S MEMORIAL PL",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813715",
            "telephone_number": "920-208-7000",
            "fax_number": "920-600-0257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 E Mill St",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "WI",
            "postal_code": "530731704",
            "country_code": "US",
            "telephone_number": "920-892-8920",
            "fax_number": "920-600-0257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEUNISSEN",
        "first_name": "JORDAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-02",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5221-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265984611",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.