McCormack Chiropractic SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3559012 Issued in WI

Legal business name

MCCORMACK CHIROPRACTIC SC

Practice address

519 Shepherds Dr
West Bend, WI 53090-8488

Phone

(262) 306-9775

Fax

(262) 306-9183

NPI assigned

Mar 26, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Regan McCormack, DCNPI 1346324340

Title

Vice President

Phone

(262) 306-9775

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Regan Roy McCormack, DC

  • Chiropractor
  • West Bend, WI
  • NPI 1346324340
  Medicare reassignment Care Compare group NPD Authorized official
• Michelle Lee McCormack, DC

  • Chiropractor
  • West Bend, WI
  • NPI 1669556601
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437277787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 SHEPHERDS DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530908488",
            "telephone_number": "262-306-9775",
            "fax_number": "262-306-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 SHEPHERDS DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530908488",
            "telephone_number": "262-306-9775",
            "fax_number": "262-306-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCORMACK CHIROPRACTIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCORMACK",
        "authorized_official_first_name": "REGAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "262-306-9775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3559012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "484231357001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38961400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Mazur, MS PT
• MB Counseling Center of West Bend, LLC
• Emily McCabe
• Andrea L McCarthy, P.T.
• Rachel McCauley, NP
• Michelle Lee McCormack, DC
• Regan Roy McCormack, DC
• Maria McDermit
• Sherry Lynne McElhatton, MT-BC
• Kevin McGinn, D.D.S.

• Chiropractor in West Bend, WI
• Providers in West Bend, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.