Bakke Chiropractic Clinic SC
Organization Active NPI Chiropractor · Deforest, WI
NPI 1306915079 · NPPES record last updated Sep 21, 2007
Key facts
- NPI
- 1306915079
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- BAKKE CHIROPRACTIC CLINIC SC
- Practice address
- Bakke Chiropractic Clinic SC
312 East North Street
Deforest, WI 53532 - Phone
- (608) 846-3337
- Fax
- (608) 846-7033
- NPI assigned
- Nov 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Gregg Nelson Bakke, DC
- Title
- President
- Phone
- (608) 846-3333
Practitioners 24
-
Michael Bollig, D.C.
-
Jill M Mikkelson, DC
-
Bailee N Scharp, DC
-
Jennifer Lynn Waldsmith, D.C.
-
Bradley T Zinkel, D.C.
-
Jennifer A Breunig, D.C.
-
Tammi Lynn Hagensick, D.C.
-
Karen L Bridge, DC
-
Ana Killean, LMT
-
Erika Minkevicius, LMT
-
Bryan J Sander, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050111001033 | WI | Part B Supplier - Clinic/Group Practice | 6002864501 |
Receives reassigned benefits from 11 practitioners Practice locations: Deforest, WI; Lodi, WI; Sun Prairie, WI; Waunakee, WI |
National Provider Directory
Locations
312 E North St
Deforest, WI 53532
Phone (608) 846-3333
801 N Main St
Ste B
Lodi, WI 53555
Phone (608) 592-1400
715 W Main St
Sun Prairie, WI 53590
Phone (608) 837-7600
725 W Main St
Sun Prairie, WI 53590
Phone (608) 837-7600
1356 N Bristol St
Sun Prairie, WI 53590
725 W Main St
Ste A
Sun Prairie, WI 53590
Phone (608) 837-7600
612 E Main St
Waunakee, WI 53597
Phone (608) 849-9014
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
Bakke Chiropractic Clinic SC
312 East North Street
Deforest, WI 53532
Mailing address
Bakke Chiropractic Clinic SC
312 East North Street
Deforest, WI 53532
Phone (608) 846-3337
Other providers in Deforest, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.