Wignall Kennedy Chiropractic Clinic SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2501 Issued in WI

Legal business name

WIGNALL KENNEDY CHIROPRACTIC CLINIC SC

Practice address

11515 W North Ave
Wauwatosa, WI 53226-2127

Phone

(414) 257-2575

Fax

(414) 257-1778

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Steven Thomas Kennedy, DCNPI 1730107269

Title

Owner

Phone

(414) 257-2575

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Steven Thomas Kennedy, DC

  • Chiropractor
  • Wauwatosa, WI
  • NPI 1730107269
  Medicare reassignment Authorized official
• Corinne Ann Kennedy, DC

  • Chiropractor
  • Milwaukee, WI
  • NPI 1922093780
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1467592972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11515 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262127",
            "telephone_number": "414-257-2575",
            "fax_number": "414-257-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262127",
            "telephone_number": "414-257-2575",
            "fax_number": "414-257-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIGNALL KENNEDY CHIROPRACTIC CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-257-2575",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38845500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark T. Wichman, M.D.
• Wider Horizons LLC
• Michael E Widlansky, M.D.
• Timothy C. Wiedel, PHD
• Charlene Wiegand
• Susan Wilbanks, PHD, ATC, CSCS
• Kennedy Wilcox
• Azarhia Wilder
• Megan E Wiley, DPT
• Colleen Ann Wilkens, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.