Essential Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3574-12 Issued in WI

Legal business name

ESSENTIAL CHIROPRACTIC LLC

Practice address

2170 Velp Ave Ste 105
Green Bay, WI 54303-6596

Phone

(920) 471-8973

Fax

(920) 465-6760

NPI assigned

Dec 14, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kay A Fogeltanz, DCNPI 1184715146

Title

Owner/Manager

Phone

(920) 471-8973

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.

• Kay Ann Fogeltanz, DC

  • Chiropractor
  • Green Bay, WI
  • NPI 1184715146
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1912200965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2969 MOSSY OAK CIR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115789",
            "telephone_number": "920-471-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 VELP AVE STE 105",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543036596",
            "telephone_number": "920-471-8973",
            "fax_number": "920-465-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "FOGELTANZ",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "920-471-8973",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3574-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erie Spine & Pain Center PC
• Kyle M Eriks Cline, NP
• Charles A Errico, MD
• Lily Ertel, PT
• Susan Kay Esmay, BSN
• Kelsey Rose Esser
• Essilor Laboratories of America, Inc.
• Trenton Estano, SAC-IT
• Jacquelyn Marie Etienne, APNP
• Lucas Joseph Evans, RRT

• Chiropractor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.