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FOND DU LAC FAMILY CHIROPRACTIC LLC
NPI 1790278695
Chiropractor in Fond Du Lac, WI

Active since June 14, 2018
103 S PIONEER RD STE 200, FOND DU LAC, WI 54935(208) 722-9639(920) 933-2511 Get Directions Write a Review

NPPES record last updated: December 28, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 28, 2021, Dec 23, 2021, Nov 16, 2021 and 1 more (4 updates tracked since 2018).

About Fond Du Lac Family Chiropractic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOND DU LAC FAMILY CHIROPRACTIC LLC (NPI 1790278695) is a healthcare organization registered as a chiropractor in Fond Du Lac, Wisconsin and active in the NPI registry since June 2018. The organization lists Scott Suprenand, Owner, as its authorized official.

NPPES Registry Identity

NPI1790278695
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameFOND DU LAC FAMILY CHIROPRACTIC LLC
Location Address103 S PIONEER RD STE 200Fond Du Lac, WI 54935-3800
Mailing Address103 S Pioneer Rd Ste 200Fond Du Lac, WI 54935-3800 · (920) 872-2969
Phone(208) 722-9639
Fax(920) 933-2511
Organization SubpartNo
Authorized OfficialScott SuprenandOwner · (920) 872-2969
Enumeration DateJune 14, 2018
Last NPPES UpdateDecember 28, 20214 updates tracked since enumeration
NPPES CertifiedDecember 28, 2021
✔ NPI 1790278695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in WI · 4745
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
103 S PIONEER RD STE 200, Fond Du Lac, WI 54935
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Other Identifiers 1

Medicaid100014403WI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare), HealthPartners, Quartz.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fond Du Lac Family Chiropractic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Fond Du Lac Family Chiropractic LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Scott Suprenand, D.C.
Chiropractic
NPI 1083903090
103 S PIONEER RD STE 200
Fond Du Lac, WI 54935
(920) 872-2969
✔ Accepts MedicareSame address
Courtney Kitzrow, D.C
Chiropractic
NPI 1619401098
103 S PIONEER RD STE 200
Fond Du Lac, WI 54935
(920) 872-2969
✔ Accepts Medicare1.7 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fond Du Lac Family Chiropractic LLC's NPI number?

The NPI number for Fond Du Lac Family Chiropractic LLC is 1790278695. It was assigned to this organization in the NPPES registry on June 14, 2018.

Where is Fond Du Lac Family Chiropractic LLC located?

Fond Du Lac Family Chiropractic LLC is located at 103 S Pioneer Rd Ste 200, Fond Du Lac, WI 54935. The listed phone number is (208) 722-9639.

What is Fond Du Lac Family Chiropractic LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Fond Du Lac Family Chiropractic LLC enrolled in Medicare?

Yes. Fond Du Lac Family Chiropractic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fond Du Lac Family Chiropractic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Chiropractic, reassign their Medicare billing to Fond Du Lac Family Chiropractic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Fond Du Lac Family Chiropractic LLC accept?

Health plans from CareSource (Common Ground Healthcare), HealthPartners and Quartz list Fond Du Lac Family Chiropractic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fond Du Lac Family Chiropractic LLC was last updated on December 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.