Individual provider Active NPI

Michaela Bonita Avila, DC

  • Chiropractor
  • Sun Prairie, WI
National Provider Identifier
1275417958
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6321-12 Issued in WI
Practice address
3120 Edmonton Dr Ste 100
Sun Prairie, WI 53590-4593
Phone
(608) 318-5300
Fax
(608) 318-5353
NPI assigned
Aug 4, 2025
Last updated
Aug 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 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 6321-12 WI Primary

Addresses

Primary practice location

3120 Edmonton Dr Ste 100
Sun Prairie, WI 53590-4593

Mailing address

3120 Edmonton Dr Ste 100
Sun Prairie, WI 53590-4593
Phone (608) 318-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250826001742 WI Practitioner - Chiropractic 1951801661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Noble Choice Chiropractic LLCGroup PAC ID 0345470597, 3 clinicians

Practice addresses (Care Compare)

3120 Edmonton Dr
Suite 100
Sun Prairie, WI 53590-4593
Phone (608) 318-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6321-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Noble Choice Chiropractic LLC Chiropractor CurrentSince Aug 13, 2025 Accepting new patients

Locations

3120 Edmonton Dr
Ste 100
Sun Prairie, WI 53590
Phone (608) 318-5300

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1275417958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 EDMONTON DR STE 100",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535904593",
            "telephone_number": "608-318-5300",
            "fax_number": "608-318-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 EDMONTON DR STE 100",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535904593",
            "telephone_number": "608-318-5300",
            "fax_number": "608-318-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "MICHAELA",
        "middle_name": "BONITA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6321-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.