NPIMap

Organization Active NPI

SD Neubauer Family Health & Wellness, PLLC

  • Chiropractor
  • Waconia, MN
National Provider Identifier
1053653683
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4015 Issued in MN
Legal business name
SD NEUBAUER FAMILY HEALTH & WELLNESS, PLLC
Doing business as
HealthSource of Chanhassen
Practice address
1429 Pond Curv
Waconia, MN 55387-3109
Phone
(612) 558-8322
NPI assigned
Mar 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Authorized official

Name
Dr. Sean D Neubauer, DCNPI 1346285418
Title
Owner
Phone
(612) 558-8322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4015 MN Primary

Addresses

Primary practice location

1429 Pond Curv
Waconia, MN 55387-3109

Mailing address

1429 Pond Curv
Waconia, MN 55387-3109
Phone (612) 558-8322

Other names 1

  • HealthSource of Chanhassen Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130619000337 MN Part B Supplier - Clinic/Group Practice 6608015888 Receives reassigned benefits from 3 practitioners
Practice locations: Chanhassen, MN

National Provider Directory

National Provider Directory
Tax ID family
Healthsource of Chanhassen2 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

470 W 78th St
Ste 100
Chanhassen, MN 55317
Phone (952) 934-1772

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363824000000",
    "number": "1053653683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 POND CURV",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553873109",
            "telephone_number": "612-558-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 POND CURV",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553873109",
            "telephone_number": "612-558-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SD NEUBAUER FAMILY HEALTH & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-03-21",
        "status": "A",
        "authorized_official_last_name": "NEUBAUER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-558-8322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource of Chanhassen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waconia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.