Individual provider Active NPI

Terry Lin Wepner, DC

  • Chiropractor
  • Berlin, WI
National Provider Identifier
1720154677
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1857012 Issued in WI
Practice address
147 N State Street
Berlin, WI 54923-1621
Phone
(920) 361-3515
Fax
(920) 361-2733
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1857012 WI Primary
Chiropractor 111N00000X 1857 WI

Addresses

Primary practice location

147 N State Street
Berlin, WI 54923-1621

Mailing address

147 N State Street
Berlin, WI 54923-1621
Phone (920) 361-3515

Other identifiers 2

IdentifierTypeStateIssuer
38784100MedicaidWI
391831491011OtherWIBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110516000406 WI Practitioner - Chiropractic 0547446106 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1857WIMDChiropractor
1857012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pace Chiropractic Office SC Chiropractor CurrentSince Jan 4, 2025 Accepting new patients
Jaskowiak Chiropractic Office SC Chiropractor CurrentSince May 10, 2022 Accepting new patients
Back & Body Therapeutic Touch, LLC PastSince Aug 1, 1997 Accepting new patients

Locations

N85W15762 Appleton Ave
Menomonee Fls, WI 53051
Phone (262) 255-9636

Organizations & group practices 3

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1720154677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 N STATE STREET",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231621",
            "telephone_number": "920-361-3515",
            "fax_number": "920-361-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 N STATE STREET",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231621",
            "telephone_number": "920-361-3515",
            "fax_number": "920-361-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEPNER",
        "first_name": "TERRY",
        "middle_name": "LIN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1857012",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1857",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38784100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "391831491011",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.

Verify at the official NPI Registry.