NPIMap

Organization Active NPI

Edward L Requet DC PA

Doing business as Requet Chiropractic Wellness Center

  • Chiropractor
  • Chanhassen, MN
National Provider Identifier
1073617320
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MN3177 Issued in MN
Legal business name
EDWARD L REQUET DC PA
Doing business as
Requet Chiropractic Wellness Center
Practice address
600 Market St
Suite 260 Requet Chiropractic Wellness Center
Chanhassen, MN 55317
Phone
(952) 975-2959
Fax
(952) 975-2973
NPI assigned
Sep 8, 2006
Last updated
Feb 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Authorized official

Name
Dr. Edward Leslie Requet, DCNPI 1790735488
Title
Owner
Phone
(952) 975-2959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MN3177 MN Primary

Addresses

Primary practice location

600 Market St
Suite 260 Requet Chiropractic Wellness Center
Chanhassen, MN 55317

Mailing address

600 Market St
Suite 260
Chanhassen, MN 55317
Phone (952) 975-2959

Other identifiers 2

IdentifierTypeStateIssuer
4C665REOtherMNBLUE CROSS
4C666REOtherMNBLUE CROSS

Other names 1

  • Requet Chiropractic Wellness Center Doing business as

National Provider Directory

National Provider Directory

Locations

600 Market St
Ste 260
Chanhassen, MN 55317
Phone (952) 975-2959

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": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1073617320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MARKET ST",
            "address_2": "SUITE 260",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "55317",
            "telephone_number": "952-975-2959",
            "fax_number": "952-975-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARKET ST",
            "address_2": "SUITE 260 REQUET CHIROPRACTIC WELLNESS CENTER",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "55317",
            "telephone_number": "952-975-2959",
            "fax_number": "952-975-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD L REQUET DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "REQUET",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-975-2959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "MN3177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4C665RE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4C666RE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Requet Chiropractic Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chanhassen, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; 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.