Organization Active NPI

Balanced Health Chiropractic, PA

  • Chiropractor
  • Plymouth, MN
National Provider Identifier
1003038464
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4632 Issued in MN
Legal business name
BALANCED HEALTH CHIROPRACTIC, PA
Practice address
12805 State Highway 55
Suite 208
Plymouth, MN 55441
Phone
(763) 557-7399
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kelly Kuka, D.C.
Title
Owner
Phone
(763) 557-7399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4632 MN Primary

Addresses

Primary practice location

12805 State Highway 55
Suite 208
Plymouth, MN 55441

Mailing address

12805 State Highway 55
Suite 208
Plymouth, MN 55441
Phone (763) 557-7399

National Provider Directory

National Provider Directory

Locations

12805 Highway 55
Ste 208
Plymouth, MN 55441
Phone (763) 331-0248

3375 Plymouth Blvd
Plymouth, MN 55447
Phone (763) 557-7399

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003038464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12805 STATE HIGHWAY 55",
            "address_2": "SUITE 208",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "763-557-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 STATE HIGHWAY 55",
            "address_2": "SUITE 208",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "763-557-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED HEALTH CHIROPRACTIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUKA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-557-7399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.