Organization Active NPI

Pellegrini Chiropractic LLC

  • Chiropractor
  • Milwaukee, WI
National Provider Identifier
1467529974
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1978 Issued in WI
Legal business name
PELLEGRINI CHIROPRACTIC LLC
Practice address
7929 N Port Washington Rd
Milwaukee, WI 53217
Phone
(414) 351-6766
Fax
(414) 351-6735
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
James Mason Pellegrini, DCNPI 1194750174
Title
Doctor
Phone
(414) 351-6766

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 1978 WI Primary

Addresses

Primary practice location

7929 N Port Washington Rd
Milwaukee, WI 53217

Mailing address

7929 N Port Washington Rd
Milwaukee, WI 53217

Other identifiers 1

IdentifierTypeStateIssuer
38906500MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070125000514 WI Part B Supplier - Clinic/Group Practice 6002817582 Receives reassigned benefits from 2 practitioners
Practice locations: West Bend, WI

National Provider Directory

National Provider Directory

Locations

7929 N Port Washington Rd
Glendale, WI 53217
Phone (414) 351-6766

524 S Main St
West Bend, WI 53095
Phone (262) 353-3733

Practitioners & affiliated clinicians

Practitioners 2

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": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1467529974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7929 N PORT WASHINGTON RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7929 N PORT WASHINGTON RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-351-6766",
            "fax_number": "414-351-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELLEGRINI CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "PELLEGRINI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MASON",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "414-351-6766",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38906500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.