Wellcorp, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WELLCORP, LLC

Doing business as

Bosquez Chiropractic and Wellness Center

Practice address

836 Willow St
Omro, WI 54963-9373

Phone

(920) 685-3015

Fax

(920) 685-3017

NPI assigned

Nov 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael L Bosquez, DC, CCEPNPI 1285632901

Title

Owner, Chiropractor

Phone

(920) 685-3015

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bosquez Chiropractic and Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Lawrence Bosquez, D.C., CCEP

  • Chiropractor
  • Omro, WI
  • NPI 1285632901
  Medicare reassignment Care Compare group NPD Authorized official
• Mitchell David Kramer, DC

  • Chiropractor
  • Omro, WI
  • NPI 1942067830
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841367646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 WILLOW ST",
            "city": "OMRO",
            "state": "WI",
            "postal_code": "549639373",
            "telephone_number": "920-685-3015",
            "fax_number": "920-685-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 WILLOW ST",
            "city": "OMRO",
            "state": "WI",
            "postal_code": "549639373",
            "telephone_number": "920-685-3015",
            "fax_number": "920-685-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCORP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOSQUEZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER, CHIROPRACTOR",
        "authorized_official_telephone_number": "920-685-3015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, CCEP"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38885500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bosquez Chiropractic and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney A Stuebs, PTA
• Melissa Jennifer Tracy
• Marylee J Ubick
• Reid Van Gysel, PHARM. D.
• Janet Veith, LPC
• Mandy Wilke, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.