Individual provider Active NPI

Irene Louise Parent, D.C.

  • Nutrition Chiropractor
  • Racine, WI
National Provider Identifier
1619042983
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
2466 Issued in WI
Practice address
3204 Washington Ave
Racine, WI 53405-3037
Phone
(262) 633-8160
Fax
(262) 633-3512
NPI assigned
Nov 22, 2006
Sex
Female
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
Nutrition Chiropractor 111NN1001X 2466 WI Primary

Addresses

Primary practice location

3204 Washington Ave
Racine, WI 53405-3037

Mailing address

3204 Washington Ave
Racine, WI 53405-3037
Phone (262) 633-8160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120113000793 WI Practitioner - Chiropractic 9537336540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2466WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeforce Chiropractic, S.C. Nutrition CurrentSince Jan 2, 1991 Accepting new patients

Locations

3204 Washington Ave
Racine, WI 53405
Phone (262) 633-8160

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619042983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534053037",
            "telephone_number": "262-633-8160",
            "fax_number": "262-633-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534053037",
            "telephone_number": "262-633-8160",
            "fax_number": "262-633-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARENT",
        "first_name": "IRENE",
        "middle_name": "LOUISE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "WI",
            "license": "2466",
            "primary": true
        }
    ],
    "identifiers": [],
    "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.