Creating Roots Wellness LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CREATING ROOTS WELLNESS LLC

Practice address

528 Shepherds Dr
West Bend, WI 53090-8488

Phone

(262) 589-1007

NPI assigned

Aug 6, 2024

Organization subpart

No

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

Authorized official

Name

Rebecca L Brown, DCNPI 1609357565

Title

Owner/Chiropractor

Phone

(262) 343-0707

Specialties & licenses 1

Addresses

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.

• Rebecca L Brown, DC

  • Chiropractor
  • West Bend, WI
  • NPI 1609357565
  NPD Authorized official

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1346070109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 SHEPHERDS DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530908488",
            "telephone_number": "262-208-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 SHEPHERDS DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530908488",
            "telephone_number": "262-589-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATING ROOTS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "262-343-0707",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi F Conway, PT
• Kerri Corcoran
• Peter L Cornelius
• Rashida Cottingham
• Kaylin Elaine Cox
• Danielle Jacqueline Creegan, M.S.
• Heather Cromb
• Peter Joshua Cronin, MD
• Chloe Cusack, MS SLP-CFY
• Melanie Custer, M.D.

• Chiropractor in West Bend, WI
• Providers in West Bend, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.