Active NPI
Bradley J Zupancich, D.C.
- Chiropractor
- La Crosse, WI
National Provider Identifier
1487714408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4201-12
- Practice address
- 4000 State Road 16 - Valley View Mall Annex
La Crosse, WI 54601-1809 - Phone
- (608) 784-3886
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4201-12 | WI | Primary |
Addresses
Primary practice location
4000 State Road 16 - Valley View Mall Annex
La Crosse, WI 54601-1809
Mailing address
4058 Beverly Dr
Onalaska, WI 54650-8425
Phone (952) 454-1842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4792 | MN | MD | Mental Health Counselor |
| 4201-12 | WI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1487714408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4058 BEVERLY DR",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546508425",
"telephone_number": "952-454-1842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 STATE ROAD 16 - VALLEY VIEW MALL ANNEX",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546011809",
"telephone_number": "608-784-3886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUPANCICH",
"first_name": "BRADLEY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2024-01-16",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "4201-12",
"primary": true
}
],
"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 Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.