The Center for Human Restoration, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4632-012 Issued in WI

Legal business name

THE CENTER FOR HUMAN RESTORATION, INC

Practice address

505 W Glen St Ste 1
Crandon, WI 54520-1356

Phone

(715) 478-5202

Fax

(715) 478-5205

NPI assigned

Sep 7, 2011

Last updated

Mar 30, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laura Jean ConnorNPI 1528348133

Title

President

Phone

(715) 478-5202

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 2

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.

• Laura Jean Connor, D.C.

  • Chiropractor
  • Crandon, WI
  • NPI 1528348133
  Medicare reassignment NPD Authorized official
• Dakota Ann Malzewski, DC

  • Chiropractor
  • Crandon, WI
  • NPI 1811554991
  Medicare reassignment NPD

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1740561521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545200039",
            "telephone_number": "715-478-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W GLEN ST STE 1",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545201356",
            "telephone_number": "715-478-5202",
            "fax_number": "715-478-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR HUMAN RESTORATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "CONNOR",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-478-5202"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "4632-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sokaogon Chippewa Community (Sokaogon Chippewa Health Clinic)
• Jodi L Space, APNP
• Shalynn Sprink
• Jennifer Lynn Stein, FNP-C
• Tina Irene Taylor
• Betty S Thunder, ADVANCED PRACTICE SO
• Kayla Charlene Van Cleve, RN
• Eve Louise Van Harpen, DDS
• Zatrina Marie Vollmar
• Jacob Ryan Wagner, D.D.S.

• Clinic/Center in Crandon, WI
• Providers in Crandon, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.