Katrina Angel Mares, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5153-12 Issued in WI

Practice address

129 Old Abe Rd
Lac Du Flambeau, WI 54538-9386

Phone

(715) 588-3371

NPI assigned

Jan 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lac Du Flambeau Band of Lake Superior Chippewa IndiansGroup PAC ID 5496707242, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katrenia.mares@pchclinic.directbygreenway.com

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

• Lac Du Flambeau Band of Lake Superior Chippewa Indians

  • Federally Qualified Health Center (FQHC)
  • Lac Du Flambeau, WI
  • NPI 1134235047

  WI

  Medicare reassignment Care Compare group NPD
• Lac Du Flambeau Band of Lake Superior Chippewa Indians

  • Federally Qualified Health Center (FQHC)
  • Lac Du Flambeau, WI
  • NPI 1306016563
  NPD

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1831556901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 OLD ABE RD",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545389386",
            "telephone_number": "715-588-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 OLD ABE RD",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545389386",
            "telephone_number": "715-588-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARES",
        "first_name": "KATRINA",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5153-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tieheena M Lemerond, SAC-IT
• Wendy Lindstrom, CADCIII
• Heather Lom, MSW, APSW
• Melissa Maki, DPT
• Nicole Maletzke, DMD
• Alissa R Martin, MSW, APSW
• Pauline Ann Martin, RN
• Deanna L Maulson-Greske, SAC-IT
• John David McCrea, DPM
• Colleen M McGuire, RDH

• All providers in Lac Du Flambeau, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.