NPIMap

Organization Active NPI

Osseo Back and Neck Clinic, P.a.

Doing business as Osseo Chiropractic Clinic

  • Radiology Chiropractor
  • Osseo, MN
National Provider Identifier
1073688065
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
License
3440 Issued in MN
Legal business name
OSSEO BACK AND NECK CLINIC, P.A.
Doing business as
Osseo Chiropractic Clinic
Practice address
220 Central Ave
Osseo, MN 55369-1245
Phone
(763) 425-5525
Fax
(763) 425-6229
NPI assigned
Nov 22, 2006
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Peter Lee Kelzenberg, D.C.NPI 1043483084
Title
Owner-President
Phone
(763) 425-5525

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
Radiology Chiropractor 111NR0200X 3440 MN Primary

Addresses

Primary practice location

220 Central Ave
Osseo, MN 55369-1245

Mailing address

220 Central Ave
Osseo, MN 55369-1245
Phone (763) 425-5525

Other identifiers 3

IdentifierTypeStateIssuer
604271OtherMNHEALTH PARTNERS
02D86OSOtherMNBCBS
44-40379OtherMNMEDICA

Other names 1

  • Osseo Chiropractic Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

220 Central Ave
Osseo, MN 55369
Phone (763) 425-5525

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": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1073688065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CENTRAL AVE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "553691245",
            "telephone_number": "763-425-5525",
            "fax_number": "763-425-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CENTRAL AVE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "553691245",
            "telephone_number": "763-425-5525",
            "fax_number": "763-425-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSSEO BACK AND NECK CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "KELZENBERG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER-PRESIDENT",
        "authorized_official_telephone_number": "763-425-5525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "MN",
            "license": "3440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "604271",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02D86OS",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "44-40379",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Osseo Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osseo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.