Organization Active NPI

Chiropractic Firsts.C.

  • Chiropractor
  • Mukwonago, WI
National Provider Identifier
1720280829
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3709-012 Issued in WI
Legal business name
CHIROPRACTIC FIRSTS.C.
Practice address
603 N Rochester St
Mukwonago, WI 53149-1139
Phone
(262) 363-5021
Fax
(262) 363-5037
NPI assigned
Jun 1, 2007
Last updated
Jul 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Authorized official

Name
Dr. Mark Davis, D.C.
Title
Owner Doctor
Phone
(262) 363-5021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3709-012 WI Primary

Addresses

Primary practice location

603 N Rochester St
Mukwonago, WI 53149-1139

Mailing address

603 N Rochester St
Mukwonago, WI 53149-1139
Phone (262) 363-5021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050222000283 WI Part B Supplier - Clinic/Group Practice 8628021466 Receives reassigned benefits from 1 practitioner
Practice locations: Mukwonago, WI

National Provider Directory

National Provider Directory

Locations

121 Wolf Run
Ste 1
Mukwonago, WI 53149
Phone (262) 363-5021

Practitioners & affiliated clinicians

Practitioners 3

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": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1720280829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 N ROCHESTER ST",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531491139",
            "telephone_number": "262-363-5021",
            "fax_number": "262-363-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N ROCHESTER ST",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531491139",
            "telephone_number": "262-363-5021",
            "fax_number": "262-363-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC FIRSTS.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "262-363-5021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3709-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukwonago, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.