Organization Active NPI

Lifetime Chiropractic Service Corporation

  • Chiropractor
  • Appleton, WI
National Provider Identifier
1720039969
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3419-012 Issued in WI
Legal business name
LIFETIME CHIROPRACTIC SERVICE CORPORATION
Practice address
1196 N Mayflower Dr
Appleton, WI 54913-9656
Phone
(920) 830-4552
Fax
(920) 830-4553
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jenifer E Espenscheid, DC
Title
President
Phone
(920) 885-4288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3419-012 WI Primary

Addresses

Primary practice location

1196 N Mayflower Dr
Appleton, WI 54913-9656

Mailing address

708 Beaver St
Beaver Dam, WI 53916-1628
Phone (920) 885-4288

Other names 1

  • Chiropractic USA Doing business as

National Provider Directory

National Provider Directory

Locations

1196 N Mayflower Dr
Appleton, WI 54913
Phone (920) 830-4552

Practitioners & affiliated clinicians

Practitioners 1

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": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720039969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 BEAVER ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161628",
            "telephone_number": "920-885-4288",
            "fax_number": "920-885-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1196 N MAYFLOWER DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139656",
            "telephone_number": "920-830-4552",
            "fax_number": "920-830-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME CHIROPRACTIC SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ESPENSCHEID",
        "authorized_official_first_name": "JENIFER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-885-4288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3419-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chiropractic USA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.