Patricia Eileen Marsden-Dull, D.C., CCSP

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

3753-012 Issued in WI

Practice address

6905 Green Bay Rd
Suite 102
Kenosha, WI 53142-1458

Phone

(262) 697-5000

Fax

(262) 697-1996

NPI assigned

Oct 2, 2006

Last updated

Dec 20, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Advanced Chiropractic, S.C.

  • Sports Physician Chiropractor
  • Kenosha, WI
  • NPI 1275699126
  NPD (past)
• Advanced Chiropractic, S.C.

  • Orthopedic Chiropractor
  • Twin Lakes, WI
  • NPI 1578629424
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1447343587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531810130",
            "telephone_number": "262-877-2196",
            "fax_number": "262-877-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 GREEN BAY RD",
            "address_2": "SUITE 102",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531421458",
            "telephone_number": "262-697-5000",
            "fax_number": "262-697-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSDEN-DULL",
        "first_name": "PATRICIA",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "D.C., CCSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WI",
            "license": "3753-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38995500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanna Mariani, M.D.
• Peter Mariani, MD
• Frank R Maritato, DDS
• Mario Benjamin Maritato, D.D.S.
• Mark J Neu PT, SC
• Eric J Marsh, MD
• Latrice Marshall, LPC-IT, SAC-IT
• Angela Martin, LPC
• Angela Maria Martin, MSW, LCSW
• Erin Martin, COTA

• Sports Physician Chiropractor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Sports Physician Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.