Organization Active NPI

Excel North Chiropractic P.a.

  • Chiropractor
  • Hermantown, MN
National Provider Identifier
1063394609
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EXCEL NORTH CHIROPRACTIC P.A.
Practice address
4135 Richard Ave Ste 102
Hermantown, MN 55811-2979
Phone
(218) 206-7775
Fax
(218) 206-7776
NPI assigned
Jul 24, 2025
Last updated
Sep 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Adam Paul Sundberg, DCNPI 1245310085
Title
Owner
Phone
(218) 340-6110

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

4135 Richard Ave Ste 102
Hermantown, MN 55811-2979

Mailing address

4135 Richard Ave Ste 102
Hermantown, MN 55811-2979
Phone (218) 340-6110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251020001453 MN Part B Supplier - Clinic/Group Practice 8123516457 Receives reassigned benefits from 1 practitioner
Practice locations: Hermantown, MN

National Provider Directory

National Provider Directory

Locations

4135 Richard Ave
Ste 102
Hermantown, MN 55811
Phone (218) 206-7775

Practitioners & affiliated clinicians

Practitioners 1

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": "1753315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1063394609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 RICHARD AVE STE 102",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112979",
            "telephone_number": "218-340-6110",
            "fax_number": "218-206-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 RICHARD AVE STE 102",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112979",
            "telephone_number": "218-206-7775",
            "fax_number": "218-206-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL NORTH CHIROPRACTIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "SUNDBERG",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-340-6110",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermantown, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.