Organization Active NPI

Peak Potential Family Chiropractic PLLC

  • Chiropractor
  • Minnetonka, MN
National Provider Identifier
1053845727
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PEAK POTENTIAL FAMILY CHIROPRACTIC PLLC
Practice address
16190 Highway 7
Minnetonka, MN 55345-3403
Phone
(952) 582-1172
NPI assigned
Apr 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Authorized official

Name
Dr. Julia Anderson, D.C.
Title
Chief Manager/ President
Phone
(952) 582-1172

Specialties & licenses 1

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

Addresses

Primary practice location

16190 Highway 7
Minnetonka, MN 55345-3403

Mailing address

16190 Highway 7
Minnetonka, MN 55345-3403
Phone (952) 582-1172

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170516000218 MN Part B Supplier - Clinic/Group Practice 1557648813 Receives reassigned benefits from 1 practitioner
Practice locations: Minnetonka, MN

National Provider Directory

National Provider Directory

Locations

16190 Highway 7
Minnetonka, MN 55345
Phone (952) 582-1172

Practitioners & affiliated clinicians

Practitioners 2

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": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1053845727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16190 HIGHWAY 7",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553453403",
            "telephone_number": "952-582-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16190 HIGHWAY 7",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553453403",
            "telephone_number": "952-582-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK POTENTIAL FAMILY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "CHIEF MANAGER/ PRESIDENT",
        "authorized_official_telephone_number": "952-582-1172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.