Peggy Sue Linneman, DC
Individual provider Active NPI Chiropractor · Whitewater, WI
NPI 1568424232 · NPPES record last updated Jun 29, 2010
Key facts
- NPI
- 1568424232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3407-012 (WI)
- Practice address
- 214 S. 2ND St.
Suite 101
Whitewater, WI 53190-2083 - Phone
- (262) 472-0209
- Fax
- (262) 472-0211
- NPI assigned
- Apr 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
214 S 2ND St
Suite 101
Whitewater, WI 53190-2083
Phone (262) 472-0209
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100903000747 | WI | Practitioner - Chiropractic | 6800910332 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3407-012 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whitewater Chiropractic, LLC | Chiropractor | Current |
Accepting new patients |
Locations
214 S 2nd St
Ste 101
Whitewater, WI 53190
Phone (262) 472-0209
Interoperability endpoints
- dr.peg@wcl0004.direct.chirotouch.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3407-012 | WI | Yes |
Addresses
Primary practice location
214 S. 2ND St.
Suite 101
Whitewater, WI 53190-2083
Mailing address
214 S. 2ND St.
Suite 101
Whitewater, WI 53190-2083
Phone (262) 472-0209
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38900000 | Medicaid | WI |
Other providers in Whitewater, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.