Spring Lake Park Chiropractic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3397 Issued in MN

Legal business name

SPRING LAKE PARK CHIROPRACTIC PA

Practice address

1611 County Highway 10
Spring Lake Park, MN 55432-2124

Phone

(763) 784-1540

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David Donald Peterson, D.C.

Title

Owner

Phone

(763) 784-1540

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Trevor Velin, DC

  • Chiropractor
  • Spring Lake Park, MN
  • NPI 1154966794
  Medicare reassignment NPD

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003941030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 COUNTY HIGHWAY 10",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554322124",
            "telephone_number": "763-784-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 COUNTY HIGHWAY 10",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554322124",
            "telephone_number": "763-784-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING LAKE PARK CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-784-1540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Shoemaker, MA, LP
• Alexandra Smith, MA, LPCC
• Kyle James Smyth, LPCC, LADC
• Spectrumworks LLC
• Spring Lake Park Chiropractic Clinic
• Spring Lake Park Dentistry PLLC
• Jonathan Charles Staiger, P.T.
• Katie Ellen Steen, M.D.
• Cynthia Steinke
• Nicole Stevenson

• Chiropractor in Spring Lake Park, MN
• Providers in Spring Lake Park, MN by specialty
• Chiropractor in Minnesota

• 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.
• 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.