Kristin Marie Wahl, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5291-12 Issued in WI

Practice address

3120 Schneider Ave SE Ste 5
Menomonie, WI 54751-2592

Phone

(715) 232-8858

Fax

(715) 232-8868

NPI assigned

Jun 1, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristin Marie Luckstead Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Restore Family Chiropractic, Inc

  • Chiropractor
  • Chippewa Falls, WI
  • NPI 1700554714
  NPD Authorized official

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992233183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAIN ST",
            "city": "CADOTT",
            "state": "WI",
            "postal_code": "547279401",
            "telephone_number": "715-289-5000",
            "fax_number": "715-289-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 SCHNEIDER AVE SE STE 5",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512592",
            "telephone_number": "715-232-8858",
            "fax_number": "715-232-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5291-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "LUCKSTEAD",
            "middle_name": "MARIE",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amber Vandermeuse, PHARMD
• Lorene L Vedder, M.D.
• Anita J Vlcek, MS LPC
• Tatiana D. Volin, DDS
• Lisa Rhea Waddell, P.T.
• Van E Wahlgren, MD
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Leah Ann Waldie, BS
• Walgreen Co

• All providers in Menomonie, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.