Mark J. Pensis Chiropractic, S.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2292-012 Issued in WI

Legal business name

MARK J. PENSIS CHIROPRACTIC, S.C.

Practice address

275 S Main St
Clintonville, WI 54929-1604

Phone

(715) 823-2912

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Shannon Helen Tremper

Title

Office Manager

Phone

(715) 823-2912

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 2

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

• Abbie Laine Fetter, DC

  • Chiropractor
  • Clintonville, WI
  • NPI 1760287676
  Medicare reassignment Care Compare group NPD
• Michael Ryan Fetter, DC

  • Chiropractor
  • Appleton, WI
  • NPI 1518612837
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558429613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 266",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "549290266",
            "telephone_number": "715-823-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 S MAIN ST",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "549291604",
            "telephone_number": "715-823-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J. PENSIS CHIROPRACTIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TREMPER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "HELEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "715-823-2912",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2292-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "391524586016",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38833800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK",
            "identifier": "6264",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Krueger, RN
• Angela Lynne Kuechler, DPT
• Curtis Leider
• John A Liebzeit, RN
• Christopher Lopez, OD
• Briana Zoe McAuly, FNP, APNP
• Janette R McDonough, LPC
• Kyle McGilligan, PHARMD
• Sara L Messner, PA
• Kelly Meyer

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.