Legacy Spine and Sport LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LEGACY SPINE AND SPORT LLC

Practice address

106 Mill St
Reedsville, WI 54230-1700

Phone

(920) 901-3382

NPI assigned

Dec 14, 2023

Last updated

Apr 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Colby Kasten, DCNPI 1417652025

Title

Chiropractor

Phone

(920) 588-7171

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Colby Kasten, DC

  • Chiropractor
  • Reedsville, WI
  • NPI 1417652025
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1669240073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MILL ST",
            "city": "REEDSVILLE",
            "state": "WI",
            "postal_code": "542301700",
            "telephone_number": "920-588-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILL ST",
            "city": "REEDSVILLE",
            "state": "WI",
            "postal_code": "542301700",
            "telephone_number": "920-901-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY SPINE AND SPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "KASTEN",
        "authorized_official_first_name": "COLBY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "920-588-7171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colby Kasten, DC
• Kirkpatrick & Associates, LLC
• Marshall L Kirkpatrick
• Robert Philip Koutnik, D.D.S.
• Amy L Lee, NP
• Karissa Loose, LPN
• Molly Jean McCulley
• Christine Pautz
• Natalie Nichole Poppe
• Reedsville School Ditrict

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.