Active NPI
Ivyanne V Elborough, DC
- Chiropractor
- Sauk City, WI
National Provider Identifier
1790355162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5643
- Practice address
- 707 Phillips Blvd
Sauk City, WI 53583-1364 - Phone
- (608) 643-8643
- Fax
- (608) 643-4902
- NPI assigned
- Jun 29, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5643 | WI | Primary |
Addresses
Primary practice location
707 Phillips Blvd
Sauk City, WI 53583-1364
Mailing address
105 Clarmar Dr
Sun Prairie, WI 53590-2675
Phone (608) 274-1945
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5643 | WI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1790355162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 CLARMAR DR",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535902675",
"telephone_number": "608-274-1945",
"fax_number": "608-318-5922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 PHILLIPS BLVD",
"city": "SAUK CITY",
"state": "WI",
"postal_code": "535831364",
"telephone_number": "608-643-8643",
"fax_number": "608-643-4902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELBOROUGH",
"first_name": "IVYANNE",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-29",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "5643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sauk City, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.