Premier Health of Coon Rapids, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5855 Issued in MN

Legal business name

PREMIER HEALTH OF COON RAPIDS, INC

Practice address

3340 Northdale Blvd NW
Suite 120
Coon Rapids, MN 55448-1622

Phone

(763) 270-5828

Fax

(763) 270-5849

NPI assigned

Sep 24, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Kelsey Chmiel, D.C.

Title

Co-Owner

Phone

(763) 270-5828

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 5

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.

• Kelsey Lyn Erickson-Chmiel, D.C.

  • Chiropractor
  • Coon Rapids, MN
  • NPI 1386068658
  Medicare reassignment
• Katelyn Emily Knaus, DC

  • Chiropractor
  • Rogers, MN
  • NPI 1043029499
  Medicare reassignment
• Alison Marie Weaver, PT, DPT

  • Physical Therapist
  • Minnetonka, MN
  • NPI 1275069676
  Medicare reassignment
• Nicole Wawra, L.AC

  • Acupuncturist
  • Coon Rapids, MN
  • NPI 1144083221
  NPD
• Eric Gordon Koehler, DC

  • Chiropractor
  • Falcon Heights, MN
  • NPI 1710002175
  NPD (past)

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1073915732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 NORTHDALE BLVD NW",
            "address_2": "SUITE 120",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554481622",
            "telephone_number": "763-270-5828",
            "fax_number": "763-270-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 NORTHDALE BLVD NW",
            "address_2": "SUITE 120",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554481622",
            "telephone_number": "763-270-5828",
            "fax_number": "763-270-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH OF COON RAPIDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "CHMIEL",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "763-270-5828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386068658",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Sarah Potter, LMFT
• Angela Kay Potts, BA, LADC
• Megan Pouliot, DNP
• Christopher A Powers, MD
• David A. Prahl Jr., CHID
• Premier Mobility
• Premier Physical Therapy Centers, Inc.
• Prestige Health Care Services
• Prestige Healthcare Solutions LLC
• Kevin G Preston, CRNA

• Chiropractor in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.