Organization Active NPI

Cody Hansen Chiropractic LLC

  • Clinic/Center
  • Weston, WI
National Provider Identifier
1689988495
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
3727 Issued in WI
Legal business name
CODY HANSEN CHIROPRACTIC LLC
Practice address
2114 Schofield Ave
Weston, WI 54476-2365
Phone
(715) 355-4224
Fax
(715) 355-4120
NPI assigned
Aug 4, 2010
Last updated
Feb 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Cody J Hansen, DCNPI 1750815031
Title
Owner
Phone
(715) 355-4224

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 3727 WI Primary
Chiropractor 111N00000X

Addresses

Primary practice location

2114 Schofield Ave
Weston, WI 54476-2365

Mailing address

2114 Schofield Ave
Weston, WI 54476-2365
Phone (715) 355-4224

Other names 1

  • Innovative Health Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110323000764 WI Part B Supplier - Clinic/Group Practice 3375726631 Receives reassigned benefits from 2 practitioners
Practice locations: Weston, WI
O20250911001874 WI Part B Supplier - Clinic/Group Practice 2860995388 Receives reassigned benefits from 2 practitioners
Practice locations: Weston, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1106114Innovative Health LLC2114 Schofield Ave, Weston, WI 54476Certificate of waiverOct 5, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1689988495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 SCHOFIELD AVE",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544762365",
            "telephone_number": "715-355-4224",
            "fax_number": "715-355-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 SCHOFIELD AVE",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544762365",
            "telephone_number": "715-355-4224",
            "fax_number": "715-355-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODY HANSEN CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-04",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-355-4224",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "3727",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Health",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Weston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.