Individual provider Active NPI

Bryton Alan Yepsen, DC

  • Chiropractor
  • Kenosha, WI
National Provider Identifier
1730675026
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5371-12 Issued in WI
Practice address
1024 60TH St
Kenosha, WI 53140-4099
Phone
(262) 657-7744
NPI assigned
Jul 10, 2018
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5731-12 WI
Chiropractor 111N00000X 5371-12 WI Primary

Addresses

Primary practice location

1024 60TH St
Kenosha, WI 53140-4099

Mailing address

1024 60TH St
Kenosha, WI 53140-4099
Phone (262) 657-7744

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180802002078 WI Practitioner - Chiropractic 6406104702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1024 60TH St
Suite 1
Kenosha, WI 53140-4099
Phone (262) 657-7744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5371-12WIMDChiropractor
5731-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Chiropractic Clinic, Inc. Chiropractor CurrentSince Jul 10, 2018 Accepting new patients

Locations

1024 60th St
Kenosha, WI 53140
Phone (262) 657-7744

1024 60th St
Ste 1
Kenosha, WI 53140
Phone (262) 657-7744

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1730675026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 60TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404099",
            "telephone_number": "262-657-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 60TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404099",
            "telephone_number": "262-657-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEPSEN",
        "first_name": "BRYTON",
        "middle_name": "ALAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5731-12",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5371-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.