Organization Active NPI

Vanwinkle Family Chiropractic, LLC

  • Chiropractor
  • Peshtigo, WI
National Provider Identifier
1972904019
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3893-012 Issued in WI
Legal business name
VANWINKLE FAMILY CHIROPRACTIC, LLC
Practice address
880 Frontage Rd
Suite H
Peshtigo, WI 54157-1725
Phone
(715) 582-4098
Fax
(715) 582-4097
NPI assigned
Sep 8, 2014
Last updated
Sep 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Authorized official

Name
Dr. Carrie Lee Vanwinkle, D.C.NPI 1790883460
Title
President
Phone
(715) 582-4098

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3893-012 WI Primary

Addresses

Primary practice location

880 Frontage Rd
Suite H
Peshtigo, WI 54157-1725

Mailing address

880 Frontage Rd
Suite H
Peshtigo, WI 54157-1725
Phone (715) 582-4098

Other identifiers 1

IdentifierTypeStateIssuer
1790883460OtherWINPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141104001745 WI Part B Supplier - Clinic/Group Practice 8224250493 Receives reassigned benefits from 1 practitioner
Practice locations: Peshtigo, WI

National Provider Directory

National Provider Directory

Locations

132 N Emery Ave
Peshtigo, WI 54157
Phone (715) 582-4098

880 Frontage Rd
Ste H
Peshtigo, WI 54157
Phone (715) 582-4098

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1972904019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 FRONTAGE RD",
            "address_2": "SUITE H",
            "city": "PESHTIGO",
            "state": "WI",
            "postal_code": "541571725",
            "telephone_number": "715-582-4098",
            "fax_number": "715-582-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 FRONTAGE RD",
            "address_2": "SUITE H",
            "city": "PESHTIGO",
            "state": "WI",
            "postal_code": "541571725",
            "telephone_number": "715-582-4098",
            "fax_number": "715-582-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANWINKLE FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A",
        "authorized_official_last_name": "VANWINKLE",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-582-4098",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3893-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790883460",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peshtigo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.