Cornerstone Chiropractic of Hortonville LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5233-12 Issued in WI

Legal business name

CORNERSTONE CHIROPRACTIC OF HORTONVILLE LLC

Practice address

223 N Pine St
Hortonville, WI 54944-9140

Phone

(920) 850-2507

NPI assigned

Feb 20, 2017

Organization subpart

No

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

Authorized official

Name

Jared Scott Bedor, DC

Title

Co-Owner

Phone

(920) 850-2507

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Richard Clausen, DC

  • Chiropractor
  • Hortonville, WI
  • NPI 1215037692
  Medicare reassignment NPD

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1730628041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "HORTONVILLE",
            "state": "WI",
            "postal_code": "549440187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N PINE ST",
            "city": "HORTONVILLE",
            "state": "WI",
            "postal_code": "549449140",
            "telephone_number": "920-850-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE CHIROPRACTIC OF HORTONVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "BEDOR",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "920-850-2507",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5233-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100064521",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brothers in Bond, LLC
• Andrew Budi, D.D.S.
• Cynthia Chitwood, RN
• Choice Physical Therapy and Wellness LLC
• Eric Richard Clausen, DC
• Deeply Rooted Chiropractic, LLC
• Dr. Clint Dunathan SC Smiles by Design SC
• Clint Arni Dunathan, D.D.S.
• Jill Everson
• Family Chiropractors Inc

• Chiropractor in Hortonville, WI
• Providers in Hortonville, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.