Individual provider Active NPI

Amy Lynne Heffernan

  • Chiropractor
  • Waukesha, WI
National Provider Identifier
1902967359
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3874 Issued in WI
Practice address
1800 E Main St Ste 300
Waukesha, WI 53186-3984
Phone
(262) 549-4555
Fax
(262) 549-9750
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3874 WI Primary

Addresses

Primary practice location

1800 E Main St Ste 300
Waukesha, WI 53186-3984

Mailing address

1800 E Main St Ste 300
Waukesha, WI 53186-3984
Phone (262) 549-4555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110527000343 WI Practitioner - Chiropractic 7416134580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1820 E Main St
Waukesha, WI 53186-3902
Phone (262) 549-4555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3874WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Heffernan Chiropractic Clinic SC Chiropractor CurrentSince Oct 1, 2002 Accepting new patients

Locations

1800 E Main St
Ste 300
Waukesha, WI 53186
Phone (262) 549-4555

1820 E Main St
Waukesha, WI 53186
Phone (262) 549-4555

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1902967359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E MAIN ST STE 300",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863984",
            "telephone_number": "262-549-4555",
            "fax_number": "262-549-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E MAIN ST STE 300",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863984",
            "telephone_number": "262-549-4555",
            "fax_number": "262-549-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "AMY",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.