Complete Chiropractic and Wellness, PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4364 Issued in MN

Legal business name

COMPLETE CHIROPRACTIC AND WELLNESS, PA

Practice address

6640 Lyndale Ave S Ste 120
Richfield, MN 55423-2385

Phone

(612) 866-1859

NPI assigned

May 15, 2007

Last updated

Aug 22, 2020By 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. Nicholas Mellum, D.C.NPI 1831102870

Title

Owner

Phone

(612) 866-1859

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

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.

• Nicholas Anthony Mellum, D.C.

  • Chiropractor
  • Richfield, MN
  • NPI 1831102870
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033325220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 LYNDALE AVE S STE 120",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232385",
            "telephone_number": "612-866-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 LYNDALE AVE S STE 120",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232385",
            "telephone_number": "612-866-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CHIROPRACTIC AND WELLNESS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MELLUM",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-866-1859",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "4364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "088L3AS",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "101645",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Lamar Coats Jr. Jr.
• Sara M Colarusso, DDS
• Dana Collins, LMT
• Complementary Support Services
• Complementary Support Services
• Context Psychotherapy LLC
• Charnea Cook-Gregory
• Josh Cook, LICSW
• Emma Luisa Lorayne Coppola
• Tessa Corbin, HID

• Clinic/Center in Richfield, MN
• Providers in Richfield, MN by specialty
• Clinic/Center 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.