Eau Claire Chiropractic, SC – Clinic/Center

Key facts

NPI: 1407035686
Entity type: Organization (NPI type 2)
Primary specialty: Clinic/Center 261Q00000X
License: 1754 (WI)
Legal business name: EAU CLAIRE CHIROPRACTIC, SC
Practice address: 4606 Commerce Valley Rd
Suite 209
Eau Claire, WI 54701-7074
Phone: (715) 832-6616
Fax: (715) 832-6454
NPI assigned: Oct 24, 2007
Organization subpart: No

Authorized official

Name: Dr. Chris Henry Hougen, D.C. NPI 1790854123
Title: President
Phone: (715) 832-6616

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 4

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

Chris Henry Hougen, D.C. Sports Physician Chiropractor · Eau Claire, WI · NPI 1790854123

Medicare reassignment Care Compare group NPD Authorized official WI
Hayden Charles Hougen, DC Chiropractor · Eau Claire, WI · NPI 1598397648

Medicare reassignment Care Compare group NPD WI
Chad James Skogstad, D.C. Sports Physician Chiropractor · Eau Claire, WI · NPI 1992877195

Medicare reassignment Care Compare group NPD WI
Denton James Kary, DC Chiropractor · Oakdale, MN · NPI 1659808517

Medicare reassignment Care Compare group NPD WI

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WI

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20040508000213	WI	Part B Supplier - Clinic/Group Practice	3072502707	Receives reassigned benefits from 4 practitioners Practice locations: Eau Claire, WI

National Provider Directory

Locations

4606 Commerce Valley Rd
Ste 209
Eau Claire, WI 54701
Phone (715) 832-6616

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinic/Center	261Q00000X	1754	WI	Yes

Addresses

Primary practice location

4606 Commerce Valley Rd
Suite 209
Eau Claire, WI 54701-7074

Mailing address

4606 Commerce Valley Rd
Suite 209
Eau Claire, WI 54701-7074
Phone (715) 832-6616

Other identifiers

Identifier	Type	State	Issuer
38733500	Medicaid	WI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 7, 2012.

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1407035686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 COMMERCE VALLEY RD",
            "address_2": "SUITE 209",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017074",
            "telephone_number": "715-832-6616",
            "fax_number": "715-832-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 COMMERCE VALLEY RD",
            "address_2": "SUITE 209",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017074",
            "telephone_number": "715-832-6616",
            "fax_number": "715-832-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAU CLAIRE CHIROPRACTIC, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "HOUGEN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-832-6616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "1754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38733500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

All providers in Eau Claire, WI · Clinic/Center in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.