Individual provider Active NPI

Anna Marie Bedogne, D.C.

  • Chiropractor
  • Kenosha, WI
National Provider Identifier
1811178759
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4453-012 Issued in WI
Practice address
618 55TH St
Kenosha, WI 53140-3753
Phone
(262) 657-8434
NPI assigned
Nov 20, 2007
Last updated
Jan 26, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009354 MI
Chiropractor 111N00000X 4453-012 WI Primary

Addresses

Primary practice location

618 55TH St
Kenosha, WI 53140-3753

Mailing address

505 S 6TH St
Escanaba, MI 49829-3919
Phone (906) 399-7059

Other names 1

  • Dr. Anna Marie Flink Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200218000185 MN Practitioner - Chiropractic 5799848636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Chester Creek ChiropracticGroup PAC ID 1355777152, 2 clinicians

Practice addresses (Care Compare)

1324 E 4TH St
Suite a
Duluth, MN 55805-2810
Phone (218) 501-0707

4570 Cty Hwy 61
Moose Lake, MN 55767-9401
Phone (218) 485-4491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009354MIMDChiropractor
4453-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Family Health Clinic, LTD. Chiropractor CurrentSince Feb 1, 2023 Accepting new patients
Chester Creek Chiropractic Chiropractor CurrentSince Dec 1, 2019 Accepting new patients
Gateway Family Health Clinic, LTD. Chiropractor CurrentSince Feb 1, 2023 Accepting new patients
Gateway Family Health Clinic, LTD. Current Accepting new patients

Locations

1324 E 4th St
Ste A
Duluth, MN 55805
Phone (218) 501-0707

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDGJBA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1811178759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 6TH ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498293919",
            "telephone_number": "906-399-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 55TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403753",
            "telephone_number": "262-657-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDOGNE",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009354",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4453-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "FLINK",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.