Brooke Cravillion

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6016-12 Issued in WI

Practice address

30 N 18TH Ave Ste 10B
Sturgeon Bay, WI 54235-3207

Phone

(920) 818-0045

NPI assigned

Oct 10, 2022

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifestyle Chiropractic & Wellness Connection LLC

  • Chiropractor
  • Green Bay, WI
  • NPI 1891897328
  Medicare reassignment NPD
• Bredael Family Chiropractic

  • Chiropractor
  • Luxemburg, WI
  • NPI 1437303575
  NPD (past)
• Luxemburg Family Chiropractic, SC

  • Chiropractor
  • Luxemburg, WI
  • NPI 1548367824
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 6, 2023.

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1609591973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 CORTLAND AVE",
            "city": "CASCO",
            "state": "WI",
            "postal_code": "542059203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 18TH AVE STE 10B",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542353207",
            "telephone_number": "920-818-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVILLION",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6016-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Counseling Associates of Door County, LLC
• County of Door-Door County Library
• County of Door-Door County Library
• County of Door-Door County Library
• Amanda Marie Court, APNP
• Colleen Dachelet
• Scott A Dadam, SAC-IT
• Lauren Daoust, LCSW
• Lori B. Dart, PT
• Sherry Lee Davidson, PTA

• All providers in Sturgeon Bay, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.