Individual provider Active NPI

Jason C Kindschi, DC

  • Chiropractor
  • Cottage Grove, WI
National Provider Identifier
1528050325
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4099 Issued in WI
Practice address
204 W Cottage Grove Rd
Cottage Grove, WI 53527-9211
Phone
(608) 839-1172
Fax
(608) 839-1174
NPI assigned
Aug 17, 2005
Last updated
Jun 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4099 WI Primary

Addresses

Primary practice location

204 W Cottage Grove Rd
Cottage Grove, WI 53527-9211

Mailing address

204 W Cottage Grove Rd
Cottage Grove, WI 53527-9211
Phone (608) 839-1172

Other identifiers 1

IdentifierTypeStateIssuer
38959000MedicaidWI

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

LicenseStateTypeSpecialty
4099WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
W & P Enterprises Inc Chiropractor PastSince May 15, 2005 Accepting new patients
Luedtke-Storm-Mackey Chiropractic Clinic SC Chiropractor PastSince Oct 13, 2022 Accepting new patients
Petersen Chiropractic Office, S.C. Chiropractor PastSince Sep 21, 2007 Accepting new patients

Organizations & group practices 3

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1528050325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W COTTAGE GROVE RD",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "535279211",
            "telephone_number": "608-839-1172",
            "fax_number": "608-839-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W COTTAGE GROVE RD",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "535279211",
            "telephone_number": "608-839-1172",
            "fax_number": "608-839-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDSCHI",
        "first_name": "JASON",
        "middle_name": "C",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38959000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.