Northwest Chiropractic and Sports Rehab LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5380-12 Issued in WI

Legal business name

NORTHWEST CHIROPRACTIC AND SPORTS REHAB LLC

Practice address

1151 E Division Ave Ste a
Barron, WI 54812

Phone

(715) 637-3000

NPI assigned

Aug 21, 2018

Organization subpart

No

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

Authorized official

Name

Brandon Michael Langerude, DC

Title

Owner

Phone

(715) 637-3000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551744000000",
    "number": "1285114983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 E DIVISION AVE STE A",
            "city": "BARRON",
            "state": "WI",
            "postal_code": "548121234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E DIVISION AVE STE A",
            "city": "BARRON",
            "state": "WI",
            "postal_code": "54812",
            "telephone_number": "715-637-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CHIROPRACTIC AND SPORTS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2019-03-05",
        "status": "A",
        "authorized_official_last_name": "LANGERUDE",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-637-3000",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5380-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100082273",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Barron, WI
• Providers in Barron, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.