Individual provider Active NPI

Melissa Ann Mechtenberg, DC

  • Chiropractor
  • Strum, WI
National Provider Identifier
1669520276
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3640-012 Issued in WI
Practice address
120 5TH Ave S
Strum, WI 54770-7931
Phone
(715) 695-2946
Fax
(715) 695-3169
NPI assigned
Jan 8, 2007
Last updated
Sep 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3640-012 WI Primary

Addresses

Primary practice location

120 5TH Ave S
Strum, WI 54770-7931

Mailing address

120 5TH Ave S
PO Box 147
Strum, WI 54770-7931
Phone (715) 695-2946

Other identifiers 1

IdentifierTypeStateIssuer
38922800MedicaidWI

Other names 1

  • Melissa Ann Mechtenberg Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050308000141 WI Practitioner - Chiropractic 4688628274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 5TH Ave N
Strum, WI 54770-9252
Phone (715) 695-2946

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3640-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Health Chiropractic Center, Inc. Chiropractor CurrentSince May 2, 2002 Accepting new patients

Locations

13801 8th St
Osseo, WI 54758
Phone (715) 695-2946

105 5th Ave N
Strum, WI 54770
Phone (715) 695-2918

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, 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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1669520276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 5TH AVE S",
            "address_2": "PO BOX 147",
            "city": "STRUM",
            "state": "WI",
            "postal_code": "547707931",
            "telephone_number": "715-695-2946",
            "fax_number": "715-695-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 5TH AVE S",
            "city": "STRUM",
            "state": "WI",
            "postal_code": "547707931",
            "telephone_number": "715-695-2946",
            "fax_number": "715-695-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECHTENBERG",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3640-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38922800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MECHTENBERG",
            "middle_name": "ANN",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Strum, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.