Evolved Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EVOLVED CHIROPRACTIC

Practice address

331 E Puetz Rd Ste 101
Oak Creek, WI 53154-3254

Phone

(414) 667-2838

NPI assigned

Dec 29, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jon Anthony Mudlaff II, DCNPI 1528701281

Title

Owner

Phone

(262) 305-9064

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jon Anthony Mudlaff Jr., DC

  • Chiropractor
  • Oak Creek, WI
  • NPI 1528701281
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1548039621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 E PUETZ RD STE 101",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531543254",
            "telephone_number": "414-667-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E PUETZ RD STE 101",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531543254",
            "telephone_number": "414-667-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVED CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "MUDLAFF",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-305-9064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DC"
    },
    "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 Oak Creek, WI
• Providers in Oak Creek, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.