Badger Chiropractic, LLC
Organization Active NPI Chiropractor · Verona, WI
NPI 1962425355 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1962425355
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3554-012 (WI)
- Legal business name
- BADGER CHIROPRACTIC, LLC
- Practice address
- 6384 Pheasant LN
Verona, WI 53593-9258 - Phone
- (608) 848-2638
- Fax
- (608) 848-2638
- NPI assigned
- Jul 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Jared D Holthe, D.C.
- Title
- Owner Chiropractor
- Phone
- (608) 848-2638
Practitioners 1
-
Jared D Holthe, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060207001004 | WI | Part B Supplier - Clinic/Group Practice | 1557376852 |
Receives reassigned benefits from 1 practitioner Practice locations: Hillsboro, WI |
National Provider Directory
Locations
621 Mechanic St
Hillsboro, WI 54634
Phone (608) 455-2320
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 3554-012 | WI | Yes |
Addresses
Primary practice location
6384 Pheasant LN
Verona, WI 53593-9258
Mailing address
6386 Pheasant LN
Verona, WI 53593-9258
Phone (608) 848-2638
Other providers in Verona, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.