NPIMap

Organization Active NPI

Rae Chiropractic, LLC

  • Chiropractor
  • Prescott, WI
National Provider Identifier
1689087876
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4444-12 Issued in WI
Legal business name
RAE CHIROPRACTIC, LLC
Practice address
1380 N Acres Rd
Prescott, WI 54021-7061
Phone
(715) 262-8555
NPI assigned
Jun 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Authorized official

Name
Carina Rae Patnode, D.C.NPI 1679601900
Title
Owner
Phone
(715) 307-7768

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4444-12 WI Primary

Addresses

Primary practice location

1380 N Acres Rd
Prescott, WI 54021-7061

Mailing address

W11199 575TH Ave
Prescott, WI 54021-7636
Phone (715) 307-7768

Other names 1

  • Prescott Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140702000010 WI Part B Supplier - Clinic/Group Practice 2062637267 Receives reassigned benefits from 4 practitioners
Practice locations: Prescott, WI

National Provider Directory

National Provider Directory

Locations

1380 N Acres Rd
Prescott, WI 54021
Phone (715) 262-8555

Practitioners & affiliated clinicians

Practitioners 7

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": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1689087876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W11199 575TH AVE",
            "city": "PRESCOTT",
            "state": "WI",
            "postal_code": "540217636",
            "telephone_number": "715-307-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 N ACRES RD",
            "city": "PRESCOTT",
            "state": "WI",
            "postal_code": "540217061",
            "telephone_number": "715-262-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "PATNODE",
        "authorized_official_first_name": "CARINA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-307-7768",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4444-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prescott Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.