Organization Active NPI

Fussy Chiropractic Health and Wellness PLLC

  • Chiropractor
  • Mankato, MN
National Provider Identifier
1083474571
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FUSSY CHIROPRACTIC HEALTH AND WELLNESS PLLC
Practice address
1400 Madison Ave Ste 700
Mankato, MN 56001-5473
Phone
(763) 354-8468
NPI assigned
Mar 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Authorized official

Name
Dr. Brittany Fussy, D.C.NPI 1740941764
Title
Chief Operating Officer
Phone
(763) 354-8468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1400 Madison Ave Ste 700
Mankato, MN 56001-5473

Mailing address

1336 N 5TH St
Mankato, MN 56001-4205
Phone (763) 354-8468

Other names 1

  • HealthSource of Mankato Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240701003044 MN Part B Supplier - Clinic/Group Practice 0547704504 Receives reassigned benefits from 1 practitioner
Practice locations: Mankato, MN

National Provider Directory

National Provider Directory

Locations

1400 Madison Ave
Ste 700
Mankato, MN 56001
Phone (763) 354-8468

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1083474571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 N 5TH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014205",
            "telephone_number": "763-354-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE STE 700",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015473",
            "telephone_number": "763-354-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUSSY CHIROPRACTIC HEALTH AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "FUSSY",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "763-354-8468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource of Mankato",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.