NPIMap

Organization Active NPI

Family Chiropractic Center, PA

  • Clinic/Center
  • Farmington, MN
National Provider Identifier
1083688345
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4381 Issued in MN
Legal business name
FAMILY CHIROPRACTIC CENTER, PA
Practice address
20700 Chippendale Ave W Ste 7
Farmington, MN 55024-8206
Phone
(651) 460-9449
Fax
(651) 279-2148
NPI assigned
Feb 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Authorized official

Name
Annie Lee Mickelson, DC
Title
Owner/President
Phone
(651) 460-9449

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 1020 MN
Clinic/Center 261Q00000X
Clinic/Center 261Q00000X 4381 MN Primary

Addresses

Primary practice location

20700 Chippendale Ave W Ste 7
Farmington, MN 55024-8206

Mailing address

20700 Chippendale Ave W Ste 7
Farmington, MN 55024-8206
Phone (651) 460-9449

Other names 1

  • Dr David E Traux Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110818000427 MN Part B Supplier - Clinic/Group Practice 0941479430 Receives reassigned benefits from 3 practitioners
Practice locations: Farmington, MN

National Provider Directory

National Provider Directory

Locations

20700 Chippendale Ave W
Ste 7
Farmington, MN 55024
Phone (651) 329-4911

Practitioners & affiliated clinicians

Practitioners 4

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": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1083688345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20700 CHIPPENDALE AVE W STE 7",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550248206",
            "telephone_number": "651-460-9449",
            "fax_number": "651-279-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20700 CHIPPENDALE AVE W STE 7",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550248206",
            "telephone_number": "651-460-9449",
            "fax_number": "651-279-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHIROPRACTIC CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "MICKELSON",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "651-460-9449",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "1020",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "4381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr David E Traux",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Farmington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.