Todd Philip Mortensen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3859-012 Issued in WI

Practice address

422 N Wisconsin St Ste a
Elkhorn, WI 53121-1318

Phone

(262) 723-3235

Fax

(262) 723-8621

NPI assigned

Jan 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Kettle Moraine Health & Wellness LLC

  • Chiropractor
  • Elkhorn, WI
  • NPI 1467503656
  Medicare reassignment NPD Authorized official
• United Chiropractic Clinic Inc

  • Chiropractor
  • Brodhead, WI
  • NPI 1174687008
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1437200714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 N WISCONSIN ST STE A",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211318",
            "telephone_number": "262-723-3235",
            "fax_number": "232-723-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 N WISCONSIN ST STE A",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211318",
            "telephone_number": "262-723-3235",
            "fax_number": "262-723-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "TODD",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3859-012",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4229",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38010724",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38943900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39004100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi L Moelling, PT
• Kristen E. Monday, BSE, MS
• Lynsea Monien, NP
• Caley Monson, DPT
• Luisa Domenica Montemurro, PT, DPT
• Stephanie Musha
• Nicolle Madison Muskevitsch, MSW, SAC-IT
• Kaylinn Anne Musto, FNP-BC
• Ramesh Muthukumar, M.D
• Kamal S Muzaffar, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.