Life Clinic, P.a.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

3221 Issued in MN

Legal business name

LIFE CLINIC, P.A.

Practice address

5525 Cedar Lake Rd S
St Louis Park, MN 55416-1420

Phone

(651) 690-0866

NPI assigned

Jan 31, 2008

Last updated

Aug 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Reza P Alizadeh, D.C.NPI 1538214598

Title

Chiropractor

Phone

(612) 868-6894

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 36

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.

• Reza Pour Alizadeh, D.C.

  • Chiropractor
  • Saint Paul, MN
  • NPI 1538214598
  Medicare reassignment NPD Authorized official
• Daniel Dino Cianni, D.C.

  • Chiropractor
  • Woodbury, MN
  • NPI 1437596350
  Medicare reassignment Care Compare group NPD
• Daniel James Daly, D.C.

  • Chiropractor
  • Shakopee, MN
  • NPI 1497145650
  Medicare reassignment Care Compare group NPD
• Benjamin Joseph Degenhardt, DC

  • Chiropractor
  • Eagan, MN
  • NPI 1114657053
  Medicare reassignment Care Compare group NPD
• Jack Erickson, DC

  • Chiropractor
  • Eagan, MN
  • NPI 1194438374
  Medicare reassignment Care Compare group NPD
• Lance Matthew Erickson, DC

  • Chiropractor
  • Edina, MN
  • NPI 1649849795
  Medicare reassignment Care Compare group NPD
• Travis Gilbertson, DC

  • Chiropractor
  • Eden Prairie, MN
  • NPI 1720595481

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Aaron C. Howe, D.C.

  • Chiropractor
  • Farmington, MN
  • NPI 1427395219
  Medicare reassignment Care Compare group NPD
• Luke Matthew Jakubowski, D.C.

  • Sports Physician Chiropractor
  • Eagan, MN
  • NPI 1649329749
  Medicare reassignment Care Compare group NPD
• Cody Neil King, DC

  • Chiropractor
  • Minneapolis, MN
  • NPI 1275343873
  Medicare reassignment Care Compare group NPD
• William B Lutz, DC, ATC, MS

  • Chiropractor
  • Saint Paul, MN
  • NPI 1851747505
  Medicare reassignment Care Compare group NPD
• Alexander M McHugh, DC

  • Chiropractor
  • Waconia, MN
  • NPI 1578224200
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1023296167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 HAMLINE AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052231",
            "telephone_number": "651-690-0866",
            "fax_number": "651-690-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 CEDAR LAKE RD S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161420",
            "telephone_number": "651-690-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "ALIZADEH",
        "authorized_official_first_name": "REZA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "612-868-6894",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MN",
            "license": "3221",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Marie Lick, R.D., L.D.
• Wayne D Liebhard, M.D.
• Jack L Liebo, M.D.
• Life and Light LLC
• Life Clinic Medical, PA
• Life Medical, P.a. (Life Medical)
• Lifeclinic PA
• Lifeclinic Rehabilitation and Chiropractic
• Lifescan Minnesota Stand Up MRI LLC
• Lifespark Home Health LLC

• Rehabilitation Chiropractor in St Louis Park, MN
• Providers in St Louis Park, 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 11, 2014; 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.