Individual provider Active NPI

Amy Kay Breidenbach, DC DICCP

  • Chiropractor
  • Onalaska, WI
National Provider Identifier
1376644567
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3732012 Issued in WI
Practice address
N5498 St Rd 35
Onalaska, WI 54650
Phone
(608) 779-5323
Fax
(608) 779-5328
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3732012 WI Primary

Addresses

Primary practice location

N5498 St Rd 35
Onalaska, WI 54650

Mailing address

N5498 St Rd 35
Onalaska, WI 54650
Phone (608) 779-5323

Other identifiers 1

IdentifierTypeStateIssuer
38930000MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111031000301 WI Practitioner - Chiropractic 4789765249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

C5560 County Rd ZM
Onalaska, WI 54650-1300
Phone (608) 779-5323

N5560 County Rd ZM
Onalaska, WI 54650-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3732012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Breidenbach Family and Sports Chiropractic Inc Chiropractor CurrentSince Jan 1, 2003 Accepting new patients
Breidenbach Prairie View Chiropractic, LLC Chiropractor CurrentSince Feb 24, 2024 Accepting new patients
Walz Physical Therapy and Wellness LLC PastSince Oct 22, 2023 Accepting new patients
Back to Health Chiropractic LLC Chiropractor Past Accepting new patients

Locations

1526 Rose St
Ste 101
La Crosse, WI 54603
Phone (608) 386-9328

1526 Rose St
Ste 102
La Crosse, WI 54603
Phone (608) 781-9880

1605 Losey Blvd S
La Crosse, WI 54601
Phone (608) 788-7880

N5560 County Road ZM
Onalaska, WI 54650
Phone (608) 397-4523

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376644567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N5498 ST RD 35",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "54650",
            "telephone_number": "608-779-5323",
            "fax_number": "608-779-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N5498 ST RD 35",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "54650",
            "telephone_number": "608-779-5323",
            "fax_number": "608-779-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREIDENBACH",
        "first_name": "AMY",
        "middle_name": "KAY",
        "credential": "DC DICCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3732012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38930000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.