Jeffrey Gene Buntrock, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2834-012 Issued in WI

Practice address

612 S Wells St
Suite C
Lake Geneva, WI 53147-2159

Phone

(262) 248-8177

Fax

(262) 248-6393

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Geneva Chiropractic PartnersGroup PAC ID 6305731506, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lake Geneva Chiropractic Partners

  • Chiropractor
  • Lake Geneva, WI
  • NPI 1407946254
  Medicare reassignment Care Compare group NPD Authorized official
• CJR Partners LLC

  • Chiropractor
  • Lake Geneva, WI
  • NPI 1942540513
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1881624823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S WELLS ST",
            "address_2": "SUITE C",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472159",
            "telephone_number": "262-248-8177",
            "fax_number": "262-248-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S WELLS ST",
            "address_2": "SUITE C",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472159",
            "telephone_number": "262-248-8177",
            "fax_number": "262-248-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNTROCK",
        "first_name": "JEFFREY",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2834-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38863200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridgelight Counseling
• Bridgelight Counseling
• Donna J Brown, DC
• Elisa Christine Brown, PHARMD
• Ashley Danielle Budreck, R.N.
• Taylor Busalacchi, PT
• Theresa Butler
• Kerri Caan, DDS
• Daniel R Caminiti, LPC
• Samuel Harrison Cannon Jr., CRNA

• Chiropractor in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.