Active NPI
Sally Jean Brown, D.C.
- Chiropractor
- Racine, WI
National Provider Identifier
1578620423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2961-012
- Practice address
- 2609 Rapids Dr
Racine, WI 53404-1741 - Phone
- (262) 638-9999
- Fax
- (262) 638-0742
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2961-012 | WI | Primary |
Addresses
Primary practice location
2609 Rapids Dr
Racine, WI 53404-1741
Mailing address
1948 Michigan Blvd
Racine, WI 53402-4759
Phone (262) 633-9908
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38873500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6240 Bankers Rd
Mount Pleasant, WI 53403-9747
Phone (262) 598-0918
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2961-012 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniels Chiropractic Office Inc | Past | Accepting new patients | |
| Chiropractic Company - Mke Downtown LTD | Chiropractor | Past | 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.
-
- Chiropractor
- Mount Pleasant, WI
- NPI 1568897445
-
dba Chiropractic Company - Milwaukee Downtown LTD
- Chiropractor
- Milwaukee, WI
- NPI 1750323242
-
- Clinic/Center
- Racine, WI
- NPI 1376715722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578620423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1948 MICHIGAN BLVD",
"city": "RACINE",
"state": "WI",
"postal_code": "534024759",
"telephone_number": "262-633-9908",
"fax_number": "262-638-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2609 RAPIDS DR",
"city": "RACINE",
"state": "WI",
"postal_code": "534041741",
"telephone_number": "262-638-9999",
"fax_number": "262-638-0742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SALLY",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "2961-012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38873500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Racine, 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.