Chippewa Valley Neurosciences LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

37138021 Issued in WI

Legal business name

CHIPPEWA VALLEY NEUROSCIENCES LLC

Practice address

950 W Clairemont Ave
Suite B
Eau Claire, WI 54701-6176

Phone

(715) 831-0811

Fax

(715) 831-0802

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jon P Konzen, DONPI 1609988310

Title

Owner

Phone

(715) 831-0811

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

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

• Jon P Konzen, DO

  • Neurology Physician
  • Eau Claire, WI
  • NPI 1609988310
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1306987771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3506 OAKWOOD MALL DR STE A",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012639",
            "telephone_number": "715-831-0811",
            "fax_number": "715-831-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W CLAIREMONT AVE",
            "address_2": "SUITE B",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016176",
            "telephone_number": "715-831-0811",
            "fax_number": "715-831-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIPPEWA VALLEY NEUROSCIENCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "KONZEN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-831-0811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "37138021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30067800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chippewa Valley Neuromonitoring, LLC
• Chippewa Valley Optical LTD
• Chippewa Valley Speech Therapy LLC
• Chippewa Valley Technical College
• Chiro One Wellness Center of Eau Claire LLC
• Chirosource, LLC

• Neurology Physician in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Neurology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.