Individual provider Active NPI

Kaitlyn Buckner, DC

  • Chiropractor
  • Neenah, WI
National Provider Identifier
1366146391
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
623212 Issued in WI
Practice address
1511 S Commercial St
Neenah, WI 54956-4801
Phone
(920) 720-0660
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 623212 WI Primary

Addresses

Primary practice location

1511 S Commercial St
Neenah, WI 54956-4801

Mailing address

1511 S Commercial St
Neenah, WI 54956-4801

Other practice location 1

279 N Altenhofen Dr
Appleton, WI 54913-8401
Phone (920) 574-2674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230404001735 IA Practitioner - Chiropractic 7810362985 Reassigns benefits to 1 organization
I20241126003269 WI Practitioner - Chiropractic 7810362985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2023
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1511 S Commercial St
Neenah, WI 54956-4801
Phone (920) 720-0660

279 N Altenhofen Dr
Appleton, WI 54913-8401
Phone (920) 720-0660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
623212WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Function First Spine and Sport, PLLC Chiropractor CurrentSince Mar 31, 2023 Accepting new patients
Schubbe Resch Chiropractic & Physical Therapy Center, LLC Chiropractor CurrentSince Nov 5, 2024 Accepting new patients

Locations

113 Avenue O W
Fort Dodge, IA 50501
Phone (515) 332-8154

604 Sumner Ave
Humboldt, IA 50548
Phone (515) 332-8154

279 N Altenhofen Dr
Appleton, WI 54913
Phone (920) 720-0660

1511 S Commercial St
Neenah, WI 54956
Phone (920) 720-0660

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1366146391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564801",
            "telephone_number": "920-720-0660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "279 N Altenhofen Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549138401",
            "country_code": "US",
            "telephone_number": "920-574-2674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "KAITLYN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "623212",
            "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 Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.