Blanchardville Chiropractic Clinic, SC

Primary specialty

Internist ChiropractorTaxonomy code 111NI0900X

License

3562-012 Issued in WI

Legal business name

BLANCHARDVILLE CHIROPRACTIC CLINIC, SC

Practice address

320 S. Main St.
Blanchardville, WI 53516-0056

Phone

(608) 523-4612

Fax

(608) 523-4614

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gina R Schultz, D.C., DABCINPI 1336275379

Title

President

Phone

(608) 523-4612

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 1

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.

• Gina Renee Schultz, D.C.

  • Internist Chiropractor
  • Blanchardville, WI
  • NPI 1336275379
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1861518623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 56",
            "address_2": "320 S. MAIN ST.",
            "city": "BLANCHARDVILLE",
            "state": "WI",
            "postal_code": "535160056",
            "telephone_number": "608-523-4612",
            "fax_number": "608-523-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S. MAIN ST.",
            "city": "BLANCHARDVILLE",
            "state": "WI",
            "postal_code": "535160056",
            "telephone_number": "608-523-4612",
            "fax_number": "608-523-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANCHARDVILLE CHIROPRACTIC CLINIC, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-523-4612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., DABCI"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Internist",
            "state": "WI",
            "license": "3562-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Kate Anderson
• Alexandria Beam, MS, CCC-SLP
• Melissa Jane Durst, MS CCC-SLP
• Kaylee A Hermansen
• Peggy Suzanne Hines, M.S. ED., LPC
• Nancy G. Johnson, LCSW SAC
• Vicki Lynn Krenz

• Internist Chiropractor in Blanchardville, WI
• Providers in Blanchardville, WI by specialty
• Internist Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.