Individual provider Active NPI

Jodi Marie Osborne, D.C.

  • Chiropractor
  • Hales Corners, WI
National Provider Identifier
1609955988
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4190-012 Issued in WI
Practice address
10920 W Forest Home Ave
Hales Corners, WI 53130-2516
Phone
(414) 235-3807
Fax
(414) 235-3839
NPI assigned
Nov 6, 2006
Last updated
Jan 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4190-012 WI Primary

Addresses

Primary practice location

10920 W Forest Home Ave
Hales Corners, WI 53130-2516

Mailing address

10920 W Forest Home Ave
Hales Corners, WI 53130-2516
Phone (414) 546-1090

Other identifiers 1

IdentifierTypeStateIssuer
38966000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4190-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Berlin Chiropractic and Therapy Center SC Chiropractor PastSince Jan 1, 1997 Accepting new patients
Alberto C Clar MD SC Past Accepting new patients
Glander Family Chiropractic, LLC Chiropractor PastSince Feb 25, 2008 Accepting new patients

Organizations & group practices 4

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1609955988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10920 W FOREST HOME AVE",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302516",
            "telephone_number": "414-546-1090",
            "fax_number": "414-546-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10920 W FOREST HOME AVE",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302516",
            "telephone_number": "414-235-3807",
            "fax_number": "414-235-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "JODI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4190-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38966000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hales Corners, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.