Organization Active NPI

Spencer-Smith Chiropractic SC

  • Chiropractor
  • Mukwonago, WI
National Provider Identifier
1316144009
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3244 Issued in WI
Legal business name
SPENCER-SMITH CHIROPRACTIC SC
Practice address
435 Rivercrest CT
Mukwonago, WI 53149-1759
Phone
(262) 363-9552
Fax
(262) 363-9556
NPI assigned
Jun 27, 2007
Last updated
Mar 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Dr. Erin Spencer-Smith, DCNPI 1598873671
Title
Owner
Phone
(262) 363-9552

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
Chiropractor 111N00000X 3244 WI Primary

Addresses

Primary practice location

435 Rivercrest CT
Mukwonago, WI 53149-1759

Mailing address

435 Rivercrest CT
Mukwonago, WI 53149-1759
Phone (262) 363-9552

Other identifiers 1

IdentifierTypeStateIssuer
38971800MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050105000840 WI Part B Supplier - Clinic/Group Practice 2466400577 Receives reassigned benefits from 2 practitioners
Practice locations: Mukwonago, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1316144009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 RIVERCREST CT",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531491759",
            "telephone_number": "262-363-9552",
            "fax_number": "262-363-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 RIVERCREST CT",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531491759",
            "telephone_number": "262-363-9552",
            "fax_number": "262-363-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCER-SMITH CHIROPRACTIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "SPENCER-SMITH",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-363-9552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38971800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukwonago, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.