Organization Active NPI

Family Friendly Chiropractic, Inc.

  • Chiropractor
  • Coon Rapids, MN
National Provider Identifier
1063546224
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3648 Issued in MN
Legal business name
FAMILY FRIENDLY CHIROPRACTIC, INC.
Practice address
1557 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4799
Phone
(763) 767-7499
Fax
(763) 767-7517
NPI assigned
Mar 16, 2007
Last updated
Jan 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Authorized official

Name
Dr. Dean A Engen, D.C.NPI 1760598080
Title
Chiropractor
Phone
(763) 767-7499

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 3648 MN Primary

Addresses

Primary practice location

1557 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4799

Mailing address

1557 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4799
Phone (763) 767-7499

Other identifiers 1

IdentifierTypeStateIssuer
231227100MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120131000154 MN Part B Supplier - Clinic/Group Practice 6800053018 Receives reassigned benefits from 1 practitioner
Practice locations: Coon Rapids, MN

National Provider Directory

National Provider Directory

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1063546224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334799",
            "telephone_number": "763-767-7499",
            "fax_number": "763-767-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1557 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334799",
            "telephone_number": "763-767-7499",
            "fax_number": "763-767-7517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FRIENDLY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "ENGEN",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "763-767-7499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231227100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.