Winnebago Chiropractic Clinic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5655 Issued in MN

Legal business name

WINNEBAGO CHIROPRACTIC CLINIC, INC.

Practice address

115 1St Ave NW
Winnebago, MN 56098-1015

Phone

(507) 893-4412

Fax

(507) 893-4912

NPI assigned

Jun 25, 2012

Last updated

Feb 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chasten Jon Fenger, DCNPI 1558620963

Title

President

Phone

(507) 893-4412

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chasten Jon Fenger, D.C.

  • Chiropractor
  • Winnebago, MN
  • NPI 1558620963
  Medicare reassignment Care Compare group NPD Authorized official
• Amy Jean Fenger, D.C.

  • Chiropractor
  • Winnebago, MN
  • NPI 1225460736
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1942563978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 1ST AVE NW",
            "address_2": "PO BOX 296",
            "city": "WINNEBAGO",
            "state": "MN",
            "postal_code": "560981015",
            "telephone_number": "507-893-4412",
            "fax_number": "507-893-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 1ST AVE NW",
            "city": "WINNEBAGO",
            "state": "MN",
            "postal_code": "560981015",
            "telephone_number": "507-893-4412",
            "fax_number": "507-893-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINNEBAGO CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "FENGER",
        "authorized_official_first_name": "CHASTEN",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-893-4412",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Winnebago, MN
• Providers in Winnebago, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.