Individual provider Active NPI

Patricia Lyn Barge, D.C.

  • Chiropractor
  • Holmen, WI
National Provider Identifier
1750421244
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2624 Issued in WI
Practice address
3812 Creekside LN
Holmen, WI 54636-9466
Phone
(608) 781-9777
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2624 WI Primary

Addresses

Primary practice location

3812 Creekside LN
Holmen, WI 54636-9466

Mailing address

3812 Creekside LN
Holmen, WI 54636-9466
Phone (608) 781-9777

Other identifiers 1

IdentifierTypeStateIssuer
38927600MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040226000648 WI Practitioner - Chiropractic 6305732280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barge Chiropractic Family and Wellness Clinic, LLCGroup PAC ID 9335394519, 4 clinicians

Practice addresses (Care Compare)

3812 Creekside LN
Holmen, WI 54636-9466
Phone (608) 781-9777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2624WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Barge Chiropractic Family & Wellness Clinic, LLC Chiropractor CurrentSince Dec 6, 2012 Accepting new patients

Locations

3812 Creekside Ln
Holmen, WI 54636
Phone (507) 452-0994

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750421244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 CREEKSIDE LN",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "546369466",
            "telephone_number": "608-781-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 CREEKSIDE LN",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "546369466",
            "telephone_number": "608-781-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARGE",
        "first_name": "PATRICIA",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38927600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmen, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.