NPIMap

Organization Active NPI

Chiropractic Rehabilitation Center, LLC

  • Chiropractor
  • Woodbury, MN
National Provider Identifier
1053562058
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIROPRACTIC REHABILITATION CENTER, LLC
Practice address
9900 Valley Creek Rd.
Suite 145
Woodbury, MN 55125
Phone
(651) 734-1123
Fax
(651) 734-1109
NPI assigned
Oct 8, 2008
Last updated
Oct 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Authorized official

Name
Jesse Jerod Crane, DCNPI 1922133602
Title
Owner
Phone
(651) 734-1123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

9900 Valley Creek Rd.
Suite 145
Woodbury, MN 55125

Mailing address

9900 Valley Creek Rd.
Suite 145
Woodbury, MN 55125
Phone (651) 734-1123

National Provider Directory

National Provider Directory
Tax ID family
Chiropractic Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9900 Valley Creek Rd
Ste 145
Woodbury, MN 55125
Phone (651) 734-1123

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223424000000",
    "number": "1053562058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 VALLEY CREEK RD.",
            "address_2": "SUITE 145",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "651-734-1123",
            "fax_number": "651-734-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 VALLEY CREEK RD.",
            "address_2": "SUITE 145",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "651-734-1123",
            "fax_number": "651-734-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A",
        "authorized_official_last_name": "CRANE",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "JEROD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-734-1123",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.