Brianna Blanck-Grott, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5051 Issued in WI

Practice address

709 Dyer St
Crivitz, WI 54114-7480

Phone

(715) 854-5025

Fax

(866) 323-0252

NPI assigned

Dec 31, 2014

Last updated

May 2, 2018By 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 3

Addresses

Other names 1

• Brianna Ludeking Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northern Chiropractic and Wellness LLC

  • Chiropractor
  • Crivitz, WI
  • NPI 1619427630
  NPD (past)
• Peterson Chiropractic Family Wellness Centre, S.C.

  dba Peterson Chiropractic

  • Orthopedic Chiropractor
  • Oconto, WI
  • NPI 1891977930
  NPD (past)

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1831587633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 593",
            "city": "CRIVITZ",
            "state": "WI",
            "postal_code": "541140593",
            "telephone_number": "715-854-5025",
            "fax_number": "866-323-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 DYER ST",
            "city": "CRIVITZ",
            "state": "WI",
            "postal_code": "541147480",
            "telephone_number": "715-854-5025",
            "fax_number": "866-323-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCK-GROTT",
        "first_name": "BRIANNA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-31",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012744",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5051-12",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "LUDEKING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abigail Rae Barley
• Bellin Memorial Hospital Inc (Bellin Health Crivitz Specialty Clinic)
• Meghan Rose Berken, PHARMD
• Kellen Blanck-Grott, D.C.
• Suzette M Bornemann, APNP
• Amanda Kay Bruins, COTA
• Jessica Bucksa, PHARMD
• Cheryl Lou Buechler, LPN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.