Amherst Chiropractic LLC
Organization Active NPI Chiropractor · Amherst, WI
NPI 1790836617 · NPPES record last updated Mar 4, 2013
Key facts
- NPI
- 1790836617
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3490-012 (WI)
- Legal business name
- AMHERST CHIROPRACTIC LLC
- Practice address
- 153 Hwy KK
Amherst, WI 54406 - Phone
- (715) 824-2725
- Fax
- (715) 824-2726
- NPI assigned
- Jan 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Kim Marie Berweger, D.C.
- Title
- Owner
- Phone
- (715) 824-2725
Practitioners 1
-
Kim Marie Berweger, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050315000713 | WI | Part B Supplier - Clinic/Group Practice | 8820043680 |
Receives reassigned benefits from 1 practitioner Practice locations: Amherst, WI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 3490-012 | WI | Yes |
Addresses
Primary practice location
153 Hwy KK
Amherst, WI 54406
Mailing address
153 Hwy KK
Amherst, WI 54406
Phone (715) 824-2725
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38925500 | Medicaid | WI |
Other providers in Amherst, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.