Organization Active NPI

Phoenix Chiropractic and Wellness, LLC

  • Chiropractor
  • Neenah, WI
National Provider Identifier
1366049793
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PHOENIX CHIROPRACTIC AND WELLNESS, LLC
Practice address
250 N Green Bay Rd
Neenah, WI 54956-2285
Phone
(920) 725-3333
NPI assigned
Oct 8, 2020
Last updated
Sep 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Melissa Burghardt, DC
Title
Chiropractor
Phone
(920) 379-4737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

250 N Green Bay Rd
Neenah, WI 54956-2285

Mailing address

250 N Green Bay Rd Unit D
Neenah, WI 54956-2285

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210317000106 WI Part B Supplier - Clinic/Group Practice 8527474550 Receives reassigned benefits from 1 practitioner
Practice locations: Neenah, WI

National Provider Directory

National Provider Directory

Locations

250 N Green Bay Rd
Ste 2
Neenah, WI 54956
Phone (920) 725-3333

250 N Green Bay Rd
Unit D
Neenah, WI 54956

Practitioners & affiliated clinicians

Practitioners 1

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": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1366049793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N GREEN BAY RD UNIT D",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N GREEN BAY RD",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562285",
            "telephone_number": "920-725-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX CHIROPRACTIC AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "BURGHARDT",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "920-379-4737",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.