Individual provider Active NPI

Andrew James Konz, D.C.

  • Chiropractor
  • Plymouth, MN
National Provider Identifier
1053649160
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5292 Issued in MN
Practice address
4345 Nathan LN N
Plymouth, MN 55442-4522
Phone
(763) 536-1112
Fax
(763) 536-0471
NPI assigned
Dec 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5292 MN Primary

Addresses

Primary practice location

4345 Nathan LN N
Plymouth, MN 55442-4522

Mailing address

1452 Kentucky Ave S
St Louis Park, MN 55426-2122
Phone (612) 237-5609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100318000381 MN Practitioner - Chiropractic 7517092398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic and Wellness Center of Albertville PLLCGroup PAC ID 0749468932, 3 clinicians

Practice addresses (Care Compare)

5676 La Centre Ave
Suite 204
Albertville, MN 55301-4023
Phone (763) 497-0777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5292MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic and Wellness Center of Albertville PLLC Chiropractor CurrentSince Jul 1, 2011 Accepting new patients
Advanced Chiropractic Health PA Chiropractor PastSince Jan 1, 2022 Accepting new patients

Locations

5676 La Centre Ave
Ste 204
Albertville, MN 55301
Phone (763) 497-0777

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.

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1053649160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 KENTUCKY AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554262122",
            "telephone_number": "612-237-5609",
            "fax_number": "763-536-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 NATHAN LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554424522",
            "telephone_number": "763-536-1112",
            "fax_number": "763-536-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONZ",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.