Active NPI
Deborah Genrick, DC
- Chiropractor
- Prior Lake, MN
National Provider Identifier
1043348402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3496
- Practice address
- 14180 Commerce Ave NE
Prior Lake, MN 55372-1483 - Phone
- (952) 447-3395
- Fax
- (953) 447-3396
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3496 | MN | Primary |
Addresses
Primary practice location
14180 Commerce Ave NE
Prior Lake, MN 55372-1483
Mailing address
7415 132ND Cir
Savage, MN 55378-1296
Phone (952) 882-8581
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3496 | MN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle Creek Chiropractic | Past | Accepting new patients | |
| Riverview Spine, P.a. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Prior Lake, MN
- NPI 1073847554
-
- Chiropractor
- Bloomington, MN
- NPI 1275742900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043348402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7415 132ND CIR",
"city": "SAVAGE",
"state": "MN",
"postal_code": "553781296",
"telephone_number": "952-882-8581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14180 COMMERCE AVE NE",
"city": "PRIOR LAKE",
"state": "MN",
"postal_code": "553721483",
"telephone_number": "952-447-3395",
"fax_number": "953-447-3396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENRICK",
"first_name": "DEBORAH",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "3496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prior Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.