Pewaukee Family Chiropractic SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3904-012 Issued in WI

Legal business name

PEWAUKEE FAMILY CHIROPRACTIC SC

Practice address

N28W23000 Roundy Dr Ste 101
Pewaukee, WI 53072-7300

Phone

(262) 695-9206

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Bradley Cristopher PearceNPI 1346391265

Title

President

Phone

(262) 695-9206

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

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

• Bradley Cristopher Pearce, D.C.

  • Chiropractor
  • Pewaukee, WI
  • NPI 1346391265
  Medicare reassignment Care Compare group NPD Authorized official
• Mandy M Pearce, DC

  • Chiropractor
  • Pewaukee, WI
  • NPI 1487661138
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1356492284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N28W23000 ROUNDY DR STE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530727300",
            "telephone_number": "262-695-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N28W23000 ROUNDY DR STE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530727300",
            "telephone_number": "262-695-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEWAUKEE FAMILY CHIROPRACTIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "PEARCE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "CRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-695-9206"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3904-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38955000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jeremy Michael Philipsen, DPM
• Abby Philleo
• Elizabeth Poser-Guenther, RN
• Premier Care of Wisconsin, LLC.
• Premier Wound Specialists, LLC

• Chiropractor in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.