Organization Active NPI

Erickson Chiropractic LLC

  • Chiropractor
  • Glenwood City, WI
National Provider Identifier
1750819082
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ERICKSON CHIROPRACTIC LLC
Practice address
107 East Oak Street
Glenwood City, WI 54013-0403
Phone
(715) 246-7500
NPI assigned
May 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Austin Erickson, DCNPI 1952533598
Title
Owner
Phone
(715) 832-3293

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

107 East Oak Street
Glenwood City, WI 54013-0403

Mailing address

PO Box 403
Glenwood City, WI 54013-0403
Phone (715) 246-7500

Other practice location 1

2863 S Prairie View Rd Ste 1
Chippewa Falls, WI 54729-3316
Phone (715) 720-9911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170718003572 WI Part B Supplier - Clinic/Group Practice 7911277363 Receives reassigned benefits from 1 practitioner
Practice locations: Chippewa Falls, WI; Glenwood City, WI

National Provider Directory

National Provider Directory

Locations

107 E Oak St
Glenwood City, WI 54013
Phone (715) 246-7500

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1750819082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403",
            "city": "GLENWOOD CITY",
            "state": "WI",
            "postal_code": "540130403",
            "telephone_number": "715-246-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 EAST OAK STREET",
            "city": "GLENWOOD CITY",
            "state": "WI",
            "postal_code": "540130403",
            "telephone_number": "715-246-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2863 S Prairie View Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Chippewa Falls",
            "state": "WI",
            "postal_code": "547293316",
            "country_code": "US",
            "telephone_number": "715-720-9911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ERICKSON CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-31",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-832-3293",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood City, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.