Organization Active NPI

Advanced Chiropractic, S.C.

  • Orthopedic Chiropractor
  • Twin Lakes, WI
National Provider Identifier
1578629424
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
2331-012 Issued in WI
Legal business name
ADVANCED CHIROPRACTIC, S.C.
Practice address
237 E Main St
Twin Lakes, WI 53181-9681
Phone
(262) 877-2196
NPI assigned
Dec 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Patricia E. Marsden, DC
Title
Office Manager
Phone
(262) 877-2196

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 2331-012 WI Primary

Addresses

Primary practice location

237 E Main St
Twin Lakes, WI 53181-9681

Mailing address

237 E Main St
PO Box 130
Twin Lakes, WI 53181-9681
Phone (262) 877-2196

Other identifiers 1

IdentifierTypeStateIssuer
38838300MedicaidWI

National Provider Directory

National Provider Directory

Locations

6905 Green Bay Rd
Ste 102
Kenosha, WI 53142
Phone (262) 697-5000

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578629424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 E MAIN ST",
            "address_2": "PO BOX 130",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531819681",
            "telephone_number": "262-877-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 E MAIN ST",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531819681",
            "telephone_number": "262-877-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CHIROPRACTIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARSDEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "262-877-2196",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "WI",
            "license": "2331-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38838300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Lakes, WI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.