Individual provider Active NPI

Angela M Prissel, DC

  • Chiropractor
  • Eau Claire, WI
National Provider Identifier
1891795571
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4036-012 Issued in WI
Practice address
431 E Clairemont Ave
Eau Claire, WI 54701-3685
Phone
(715) 832-2223
Fax
(715) 832-7416
NPI assigned
Jul 26, 2005
Last updated
Jan 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4036-012 WI Primary

Addresses

Primary practice location

431 E Clairemont Ave
Eau Claire, WI 54701-3685

Mailing address

431 E Clairemont Ave
Eau Claire, WI 54701-3685
Phone (715) 832-2223

Other identifiers 1

IdentifierTypeStateIssuer
043732396010OtherWIBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629001618 WI Practitioner - Chiropractic 5193701068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

829 W Clairemont Ave
Eau Claire, WI 54701-6102
Phone (715) 833-3505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4036-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
SPS Integrated Therapies, LLC Current Accepting new patients
Prissel Chiropractic LLC Chiropractor CurrentSince Jan 1, 2012 Accepting new patients
Eau Claire Spine & Orthopedics, SC Past Accepting new patients

Locations

829 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 833-3505

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1891795571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 E CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547013685",
            "telephone_number": "715-832-2223",
            "fax_number": "715-832-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547013685",
            "telephone_number": "715-832-2223",
            "fax_number": "715-832-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRISSEL",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4036-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "043732396010",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.