NPIMap

Organization Active NPI

Pain Relief Chiropractic

  • Chiropractor
  • Jefferson, WI
National Provider Identifier
1295177673
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4242-012 Issued in WI
Legal business name
PAIN RELIEF CHIROPRACTIC
Practice address
109 E Milwaukee St
Jefferson, WI 53549-1635
Phone
(920) 674-6627
NPI assigned
Jul 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Authorized official

Name
William LustNPI 1164533758
Title
Owner
Phone
(920) 674-6627

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4242-012 WI Primary

Addresses

Primary practice location

109 E Milwaukee St
Jefferson, WI 53549-1635

Mailing address

109 E Milwaukee St
Jefferson, WI 53549-1635
Phone (920) 674-6627

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1295177673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E MILWAUKEE ST",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535491635",
            "telephone_number": "920-674-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E MILWAUKEE ST",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535491635",
            "telephone_number": "920-674-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN RELIEF CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "LUST",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-674-6627"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4242-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.