Vadnais Heights Family Chiropractic, Inc.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

4396 Issued in MN

Legal business name

VADNAIS HEIGHTS FAMILY CHIROPRACTIC, INC.

Doing business as

Performance Chiropractic and Rehab

Practice address

1038 Centerville Cir
Vadnais Heights, MN 55127-6344

Phone

(651) 762-7475

Fax

(651) 762-7544

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Jon Hallingstad, D.C.

Title

President

Phone

(651) 762-7475

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Performance Chiropractic and Rehab Doing business as

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, and the practitioner matching its NPPES authorized official.

• Mike Jon Hallingstad, D.C.

  • Chiropractor
  • Vadnais Heights, MN
  • NPI 1043356371
  Medicare reassignment NPD

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023222478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1038 CENTERVILLE CIR",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551276344",
            "telephone_number": "651-762-7475",
            "fax_number": "651-762-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 CENTERVILLE CIR",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551276344",
            "telephone_number": "651-762-7475",
            "fax_number": "651-762-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VADNAIS HEIGHTS FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALLINGSTAD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-762-7475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MN",
            "license": "4396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "056K3VA",
            "identifier": "BLUE CROSS BLUE SHIE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Chiropractic and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rehabilitation Chiropractor in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Rehabilitation 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.