NPIMap

Organization Active NPI

Wilson Chiropractic LLC

  • Chiropractor
  • Brookfield, WI
National Provider Identifier
1407235674
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5035-12 Issued in WI
Legal business name
WILSON CHIROPRACTIC LLC
Practice address
19265 W Capitol Dr Ste 102
Brookfield, WI 53045-2750
Phone
(262) 465-8340
Fax
(262) 465-8337
NPI assigned
May 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Nicholas Wilson, DCNPI 1962807065
Title
Owner
Phone
(262) 465-8340

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5035-12 WI Primary

Addresses

Primary practice location

19265 W Capitol Dr Ste 102
Brookfield, WI 53045-2750

Mailing address

19265 W Capitol Dr Ste 102
Brookfield, WI 53045-2750
Phone (262) 465-8340

Other names 1

  • Pure Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150618001399 WI Part B Supplier - Clinic/Group Practice 9830400704 Receives reassigned benefits from 1 practitioner
Practice locations: Brookfield, WI

National Provider Directory

National Provider Directory
Tax ID family
Pure Family Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

19265 W Capitol Dr
Unit B
Brookfield, WI 53045

19265 W Capitol Dr
Ste 102
Brookfield, WI 53045
Phone (262) 465-8340

19265 W Capitol Dr
#B
Brookfield, WI 53045
Phone (262) 465-8340

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1407235674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19265 W CAPITOL DR STE 102",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452750",
            "telephone_number": "262-465-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19265 W CAPITOL DR STE 102",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452750",
            "telephone_number": "262-465-8340",
            "fax_number": "262-465-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-465-8340",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5035-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pure Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.