Individual provider Active NPI

Jon P Stowe, DC

  • Chiropractor
  • Black River Falls, WI
National Provider Identifier
1568507465
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3412 Issued in WI
Practice address
438 N Water St
Black River Falls, WI 54615-1005
Phone
(171) 528-4555
Fax
(171) 528-4916
NPI assigned
Feb 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3412 WI Primary

Addresses

Primary practice location

438 N Water St
Black River Falls, WI 54615-1005

Mailing address

438 N Water St
Black River Falls, WI 54615-1005
Phone (171) 528-4555

Other identifiers 1

IdentifierTypeStateIssuer
38992500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110223001186 WI Practitioner - Chiropractic 3779764758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jordan Chiropractic Clinic S.C.Group PAC ID 1153502117, 3 clinicians

Practice addresses (Care Compare)

438 N Water St
Black River Falls, WI 54615-1005
Phone (715) 284-5551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3412WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jessen Family Chiropractic Clinic Inc Chiropractor CurrentSince Feb 24, 1997 Accepting new patients

Locations

438 N Water St
Blk River Fls, WI 54615
Phone (715) 284-5551

Organizations & group practices 1

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568507465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 N WATER ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546151005",
            "telephone_number": "171-528-4555",
            "fax_number": "171-528-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 N WATER ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546151005",
            "telephone_number": "171-528-4555",
            "fax_number": "171-528-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOWE",
        "first_name": "JON",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38992500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.