Individual provider Active NPI

Jason Todd Stephens, D.C.

  • Chiropractor
  • Rice Lake, WI
National Provider Identifier
1699864108
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4541 Issued in WI
Practice address
2021 Cenex Dr
Suite E
Rice Lake, WI 54868-1891
Phone
(715) 234-9876
Fax
(715) 234-0855
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4541 WI Primary
Chiropractor 111N00000X 4257 CO

Addresses

Primary practice location

2021 Cenex Dr
Suite E
Rice Lake, WI 54868-1891

Mailing address

225 S Main St
Rice Lake, WI 54868-2231
Phone (715) 234-9876

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091202000629 WI Practitioner - Chiropractic 6204975386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

225 S Main St
Rice Lake, WI 54868-2231
Phone (715) 234-9876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4257COMDProfessional Counselor
4541WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stephens Chiropractic, S.C. Chiropractor CurrentSince Jan 14, 2013 Accepting new patients
Tell Peck Chiropractic Inc Chiropractor Past Accepting new patients
Kromrey Chiropractic, S.C. Chiropractor PastSince Jan 1, 2005 Accepting new patients
Wissota Chiropractic Chiropractor PastSince Oct 15, 2014 Accepting new patients
Priority Chiropractic Wellness Center, LLC Chiropractor PastSince Aug 23, 2020 Accepting new patients

Locations

2021 Cenex Dr
Unit E
Rice Lake, WI 54868
Phone (715) 234-9876

225 S Main St
Rice Lake, WI 54868
Phone (715) 234-9876

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1699864108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S MAIN ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548682231",
            "telephone_number": "715-234-9876",
            "fax_number": "715-234-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 CENEX DR",
            "address_2": "SUITE E",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681891",
            "telephone_number": "715-234-9876",
            "fax_number": "715-234-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "JASON",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4541",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "4257",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.