Southside Chiropractic, P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2085 Issued in MN

Legal business name

SOUTHSIDE CHIROPRACTIC, P.A.

Practice address

5536 Chicago Ave
Minneapolis, MN 55417-2446

Phone

(612) 827-0657

Fax

(612) 827-3102

NPI assigned

Feb 19, 2008

Last updated

Feb 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lee Ann Herfort, D.C.NPI 1780683458

Title

Owner

Phone

(612) 827-0657

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 6

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.

• Katy-Cecilie Johannessen, DC

  • Chiropractor
  • Minneapolis, MN
  • NPI 1538820535
  Medicare reassignment Care Compare group NPD
• Laura Ann O'Gorman, DC

  • Chiropractor
  • Minneapolis, MN
  • NPI 1588247118
  Medicare reassignment Care Compare group NPD
• Lee Ann Herfort, D.C.

  • Chiropractor
  • Minneapolis, MN
  • NPI 1780683458
  Authorized official Same address or phone
• Nichole Alexandra Borell, D.C.

  • Chiropractor
  • Minneapolis, MN
  • NPI 1013143858
  NPD
• Melissa Ann Kangas, MASSAGE THERAPIST

  • Massage Therapist
  • Minneapolis, MN
  • NPI 1003686130
  NPD (past)
• Michelle Kristine Reisinger, DC

  • Chiropractor
  • Byron, MN
  • NPI 1023188802
  NPD (past)

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1063680478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5536 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172446",
            "telephone_number": "612-827-0657",
            "fax_number": "612-827-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5536 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172446",
            "telephone_number": "612-827-0657",
            "fax_number": "612-827-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "HERFORT",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-827-0657",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeast Asian Refugee Community Home
• Southgate Physical Therapy , LTD
• Southpointe Physical Therapy LLC
• Southside Care Center
• Southside Catering
• Southside Community Health Services, Inc.
• Southside Community Health Services, Inc. (Southside East Lake Street Dental Clinic)
• Southside Community Health Services, Inc.
• Southside Community Health Services, Inc.
• Southside Community Health Services, Inc.

• Chiropractor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.