Individual provider Active NPI

Courtney Kitzrow, D.C

  • Chiropractor
  • Fond Du Lac, WI
National Provider Identifier
1619401098
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5682-12 Issued in WI
Practice address
103 S Pioneer Rd Ste 200
Fond Du Lac, WI 54935-3800
Phone
(920) 872-2969
NPI assigned
Apr 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5682-12 WI Primary

Addresses

Primary practice location

103 S Pioneer Rd Ste 200
Fond Du Lac, WI 54935-3800

Mailing address

103 S Pioneer Rd Ste 200
Fond Du Lac, WI 54935-3800
Phone (920) 872-2969

Other names 1

  • Courtney Bumgarner Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230623000743 WI Practitioner - Chiropractic 0244517837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fond Du Lac Family Chiropractic LLCGroup PAC ID 9032466552, 2 clinicians

Practice addresses (Care Compare)

103 S Pioneer Rd
Suite 200
Fond Du Lac, WI 54935-3800
Phone (920) 872-2969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5682-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fletcher Chiropractic Office Chiropractor CurrentSince Jul 10, 2023 Accepting new patients
Integrated Spine and Pain Center PLLC Past Accepting new patients

Locations

1150 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 230-2800

440 N Koeller St
Oshkosh, WI 54902
Phone (920) 230-2525

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.

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1619401098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S PIONEER RD STE 200",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353800",
            "telephone_number": "920-872-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S PIONEER RD STE 200",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353800",
            "telephone_number": "920-872-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITZROW",
        "first_name": "COURTNEY",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5682-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "BUMGARNER",
            "credential": "D.C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; 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.

Verify at the official NPI Registry.