Plymouth Grove Chiropractic, P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

280 Issued in MN

Legal business name

PLYMOUTH GROVE CHIROPRACTIC, P.A.

Practice address

3900 Vinewood LN N
Suite 19
Plymouth, MN 55441-1155

Phone

(763) 559-9236

Fax

(763) 559-7486

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Vivi-Ann Rae Fischer, D.C.

Title

President

Phone

(763) 559-9236

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073569927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 VINEWOOD LN N",
            "address_2": "SUITE 19",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411155",
            "telephone_number": "763-559-9236",
            "fax_number": "763-559-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 VINEWOOD LN N",
            "address_2": "SUITE 19",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411155",
            "telephone_number": "763-559-9236",
            "fax_number": "763-559-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH GROVE CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "VIVI-ANN",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-559-9236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.