Gayle Ann Nissen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2462 Issued in WI

Practice address

187 E Main St
Ellsworth, WI 54011

Phone

(715) 273-5290

NPI assigned

Oct 31, 2006

Last updated

Apr 20, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ellsworth Chiropractic and Wellness LLCGroup PAC ID 7012422926, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ellsworth Chiropractic & Wellness LLC

  • Chiropractor
  • Ellsworth, WI
  • NPI 1235927930
  Medicare reassignment Care Compare group NPD
• Ellsworth Chiropractic Inc

  • Chiropractor
  • Ellsworth, WI
  • NPI 1659557510
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1801972898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "ELLSWORTH",
            "state": "WI",
            "postal_code": "540110668",
            "telephone_number": "715-273-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 E MAIN ST",
            "city": "ELLSWORTH",
            "state": "WI",
            "postal_code": "54011",
            "telephone_number": "715-273-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSEN",
        "first_name": "GAYLE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH SERVICES MGMT",
            "identifier": "411508205",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD OF MN",
            "identifier": "64363NI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "392040911010",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Colette Martin, BSW
• Bridget Marie McConnell, LCSW, LICSW
• Michelle Jean Meinen, CSW
• Richard Allen Moldenhauer, LADC, LPCC,LCADC
• Hannah Newman, SAC-IT
• Northwest Journey - Ellsworth
• NSH Ellsworth LLC (Ellsworh Health Services)
• Nyeggen Chiropractic SC
• Ronald Scott Nyeggen, DC
• Laurie O'Neil

• Chiropractor in Ellsworth, WI
• Providers in Ellsworth, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.