NPIMap

Organization Active NPI

Mosinee Family Chiropractic SC

  • Chiropractor
  • Mosinee, WI
National Provider Identifier
1922471432
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1418-012 Issued in WI
Legal business name
MOSINEE FAMILY CHIROPRACTIC SC
Practice address
107 Maple St
Mosinee, WI 54455-1924
Phone
(715) 693-4144
NPI assigned
Nov 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Authorized official

Name
Kelly Alida Sackmann
Title
Billing Manager
Phone
(715) 693-4144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1418-012 WI Primary

Addresses

Primary practice location

107 Maple St
Mosinee, WI 54455-1924

Mailing address

107 Maple St
Mosinee, WI 54455-1924
Phone (715) 693-4144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151221001480 WI Part B Supplier - Clinic/Group Practice 2567763345 Receives reassigned benefits from 2 practitioners
Practice locations: Mosinee, WI

National Provider Directory

National Provider Directory

Locations

107 Maple St
Mosinee, WI 54455
Phone (715) 693-4144

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1922471432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MAPLE ST",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551924",
            "telephone_number": "715-693-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MAPLE ST",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551924",
            "telephone_number": "715-693-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSINEE FAMILY CHIROPRACTIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-05",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "SACKMANN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ALIDA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "715-693-4144"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1418-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mosinee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.