Wausau Spine & Rehab LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WAUSAU SPINE & REHAB LLC

Practice address

613 N 5TH St Ste 103
Wausau, WI 54403-4836

Phone

(715) 870-2222

NPI assigned

Jan 11, 2024

Organization subpart

No

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

Authorized official

Name

Robert Devine

Title

Owner/Chiropractor

Phone

(715) 579-0107

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1508637265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E9067 490TH AVE",
            "city": "ELK MOUND",
            "state": "WI",
            "postal_code": "547399201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 N 5TH ST STE 103",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544034836",
            "telephone_number": "715-870-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUSAU SPINE & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "DEVINE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "715-579-0107"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.