Organization Active NPI

Francis Chiropractic Clinic SC

  • Chiropractor
  • Plymouth, WI
National Provider Identifier
1629138169
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FRANCIS CHIROPRACTIC CLINIC SC
Practice address
1005 Eastern Ave
Plymouth, WI 53073-1920
Phone
(920) 892-4833
Fax
(920) 892-2106
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Authorized official

Name
Erin Tucker
Title
Office Manager
Phone
(920) 892-4833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1005 Eastern Ave
Plymouth, WI 53073-1920

Mailing address

1005 Eastern Ave
Plymouth, WI 53073-1920
Phone (920) 892-4833

Other identifiers 1

IdentifierTypeStateIssuer
34174160015OtherWIBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070504000249 WI Part B Supplier - Clinic/Group Practice 5991801193 Receives reassigned benefits from 2 practitioners
Practice locations: Plymouth, WI

National Provider Directory

National Provider Directory

Locations

1005 Eastern Ave
Plymouth, WI 53073
Phone (920) 419-4727

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1629138169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 EASTERN AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530731920",
            "telephone_number": "920-892-4833",
            "fax_number": "920-892-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 EASTERN AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530731920",
            "telephone_number": "920-892-4833",
            "fax_number": "920-892-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCIS CHIROPRACTIC CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-892-4833"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "34174160015",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.