Individual provider Active NPI

Ross Mundinger, DC

  • Chiropractor
  • La Crosse, WI
National Provider Identifier
1447630751
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5101-12 Issued in WI
Practice address
1022 19TH St S
La Crosse, WI 54601-5811
Phone
(608) 519-5690
NPI assigned
Jun 2, 2015
Last updated
Jun 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5101-12 WI Primary
Chiropractor 111N00000X 038012616 IL

Addresses

Primary practice location

1022 19TH St S
La Crosse, WI 54601-5811

Mailing address

1022 19TH St S
La Crosse, WI 54601-5811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717000720 WI Practitioner - Chiropractic 6204155930 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5101-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Breidenbach Family and Sports Chiropractic Inc Chiropractor CurrentSince Jun 22, 2020 Accepting new patients
Breidenbach Prairie View Chiropractic, LLC Chiropractor PastSince Jul 16, 2023 Accepting new patients
Walz Physical Therapy and Wellness LLC PastSince Oct 22, 2023 Accepting new patients
Back to Health Chiropractic LLC Chiropractor Past Accepting new patients

Locations

1526 Rose St
La Crosse, WI 54603
Phone (608) 317-4644

1526 Rose St
Ste 102
La Crosse, WI 54603
Phone (608) 781-9880

1605 Losey Blvd S
La Crosse, WI 54601
Phone (608) 788-7880

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1447630751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 19TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 19TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015811",
            "telephone_number": "608-519-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDINGER",
        "first_name": "ROSS",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5101-12",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012616",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; 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.