NPIMap

Organization Active NPI

Carlson Chiropractic Health and Healing Inc.

  • Chiropractor
  • Maple Plain, MN
National Provider Identifier
1083747711
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MN4108 Issued in MN
Legal business name
CARLSON CHIROPRACTIC HEALTH AND HEALING INC.
Practice address
4960 Highway 12
Maple Plain, MN 55359-8729
Phone
(763) 479-3388
Fax
(763) 479-3388
NPI assigned
Mar 13, 2007
Last updated
Jun 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Authorized official

Name
Dr. Benjamin Carlson, D.C.NPI 1619163227
Title
Doctor of Chiropractic
Phone
(763) 479-3388

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
Chiropractor 111N00000X MN4108 MN Primary

Addresses

Primary practice location

4960 Highway 12
Maple Plain, MN 55359-8729

Mailing address

4960 Highway 12
Maple Plain, MN 55359-8729
Phone (763) 479-3388

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000103 MN Part B Supplier - Clinic/Group Practice 2264475243 Receives reassigned benefits from 1 practitioner
Practice locations: Maple Plain, MN

National Provider Directory

National Provider Directory

Locations

4960 Highway 12
Maple Plain, MN 55359
Phone (763) 479-3388

Practitioners & affiliated clinicians

Practitioners 56

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.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435190400000",
    "number": "1083747711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 HIGHWAY 12",
            "city": "MAPLE PLAIN",
            "state": "MN",
            "postal_code": "553598729",
            "telephone_number": "763-479-3388",
            "fax_number": "763-479-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 HIGHWAY 12",
            "city": "MAPLE PLAIN",
            "state": "MN",
            "postal_code": "553598729",
            "telephone_number": "763-479-3388",
            "fax_number": "763-479-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLSON CHIROPRACTIC HEALTH AND HEALING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2015-06-25",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "763-479-3388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "MN4108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Plain, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; 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.