Active NPI
Prohealth Chiropractic Center S.C.
- Clinic/Center
- Random Lake, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- PROHEALTH CHIROPRACTIC CENTER S.C.
- Practice address
- 321 Carroll St
Random Lake, WI 53075-1813 - Phone
- (920) 994-2000
- NPI assigned
- Apr 6, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Eric Stanenas, D.C.
- Title
- Owner
- Phone
- (414) 617-9470
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
321 Carroll St
Random Lake, WI 53075-1813
Mailing address
321 Carroll St
Random Lake, WI 53075-1813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Prohealth Chiro Center SC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Chiropractor
- Thiensville, WI
- NPI 1871934026
Locations
407 N Main St
Thiensville, WI 53092
Phone (262) 242-3000
Practitioners & affiliated clinicians
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.
-
- Chiropractor
- Stevens Point, WI
- NPI 1457655847
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302048000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1304380800000",
"number": "1699064022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 CARROLL ST",
"city": "RANDOM LAKE",
"state": "WI",
"postal_code": "530751813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 CARROLL ST",
"city": "RANDOM LAKE",
"state": "WI",
"postal_code": "530751813",
"telephone_number": "920-994-2000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROHEALTH CHIROPRACTIC CENTER S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2011-04-06",
"last_updated": "2011-05-03",
"status": "A",
"authorized_official_last_name": "STANENAS",
"authorized_official_first_name": "ERIC",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "414-617-9470",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Random Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; 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.