Brandon Koxlien, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5053-12 Issued in WI

Practice address

322 W 1St St
Blair, WI 54616-8927

Phone

(608) 386-9441

NPI assigned

Dec 2, 2014

Last updated

Dec 2, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Black River Chiropractic Clinic SCGroup PAC ID 6709884679, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Black River Chiropractic Clinic, SC

  • Chiropractor
  • Black River Falls, WI
  • NPI 1689747826
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1366849515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 W 1ST ST",
            "city": "BLAIR",
            "state": "WI",
            "postal_code": "546168927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W 1ST ST",
            "city": "BLAIR",
            "state": "WI",
            "postal_code": "546168927",
            "telephone_number": "608-386-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOXLIEN",
        "first_name": "BRANDON",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5053-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand View Care Center Inc (Grand View Care Center)
• Gundersen Clinic, LTD.
• Michelle Halverson
• Hogden Enterprises Inc (Blair Pharmacy)
• Hogden Enterprises Inc (The Blair Pharmacy)
• Danielle Clare Matuszak, COTA
• Brittany Miller
• William G Miller
• Daniel Ben Molstad, RPH
• Shawna Rae Pientok, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.