Performance Chiropractic Center, S.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4451-012 Issued in WI

Legal business name

PERFORMANCE CHIROPRACTIC CENTER, S.C.

Practice address

11430 W Bluemound Rd Ste 203
Wauwatosa, WI 53226-4050

Phone

(414) 426-9677

NPI assigned

Mar 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey William Grosskofp, D.C.

Title

Owner/Chiropractor

Phone

(414) 426-9677

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237334400000",
    "number": "1649411703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11430 W BLUEMOUND RD STE 203",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264050",
            "telephone_number": "414-426-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11430 W BLUEMOUND RD STE 203",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264050",
            "telephone_number": "414-426-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE CHIROPRACTIC CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2009-03-18",
        "status": "A",
        "authorized_official_last_name": "GROSSKOFP",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "414-426-9677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4451-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE APPLICATION TRACKING ID",
            "identifier": "T031020090000051",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn Pepe
• Melvin Byron Pepper, PA-C
• Andres Peralta-Werns, DC
• Matthew Perchuk, P.T.
• Jennifer Mary Perez, RN
• Performance Chiropractic Clinic, LLC
• Thomas J Perlewitz, MD
• Perry W Sukowatey DDS LTD
• Madalyn Jessica Perry, D.C
• Suncerrae Perry, MSW, APSW, SAC-IT

• Chiropractor in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; 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.