Individual provider Active NPI

Jenifer Baum, D.C.

  • Chiropractor
  • Delafield, WI
National Provider Identifier
1275926701
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5077-12 Issued in WI
Practice address
403 Genesee St
Delafield, WI 53018-1814
Phone
(262) 646-6400
Fax
(262) 646-6443
NPI assigned
Mar 9, 2015
Last updated
Mar 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5077-12 WI Primary

Addresses

Primary practice location

403 Genesee St
Delafield, WI 53018-1814

Mailing address

403 Genesee St
Delafield, WI 53018-1814
Phone (262) 646-6400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150410001655 WI Practitioner - Chiropractic 3678891280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Delafield Chiropractic LLCGroup PAC ID 5193800100, 2 clinicians

Practice addresses (Care Compare)

403 Genesee St
Delafield, WI 53018-1814
Phone (262) 646-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5077-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Delafield Chiropractic LLC Chiropractor CurrentSince Apr 15, 2015 Accepting new patients

Locations

403 Genesee St
Delafield, WI 53018
Phone (262) 646-6400

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": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1275926701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 GENESEE ST",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181814",
            "telephone_number": "262-646-6400",
            "fax_number": "262-646-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 GENESEE ST",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181814",
            "telephone_number": "262-646-6400",
            "fax_number": "262-646-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUM",
        "first_name": "JENIFER",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5077-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delafield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.