Active NPI
Emily Jakusz Stevenson, DC
- Chiropractor
- Plover, WI
National Provider Identifier
1689202285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5502-12
- Practice address
- 2841 Mecca Dr
Plover, WI 54467-3228 - Phone
- (715) 570-0664
- NPI assigned
- Mar 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5502-12 | WI | Primary |
Addresses
Primary practice location
2841 Mecca Dr
Plover, WI 54467-3228
Mailing address
480 W Karner St
Stevens Point, WI 54481-3417
Phone (715) 570-0664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502-12 | WI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1689202285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 W KARNER ST",
"city": "STEVENS POINT",
"state": "WI",
"postal_code": "544813417",
"telephone_number": "715-570-0664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2841 MECCA DR",
"city": "PLOVER",
"state": "WI",
"postal_code": "544673228",
"telephone_number": "715-570-0664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "EMILY",
"middle_name": "JAKUSZ",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-30",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "5502-12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plover, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.