Chiropractic Rehabilitation Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3831 Issued in MN

Legal business name

CHIROPRACTIC REHABILITATION CENTER LLC

Practice address

9900 Valley Creek Rd #145
Woodbury, MN 55125

Phone

(651) 734-1123

Fax

(651) 734-1109

NPI assigned

Jan 9, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jesse Jerod Crane, DCNPI 1922133602

Title

Owner Ceo

Phone

(651) 734-1123

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Tax ID family

Chiropractic Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Chiropractic Rehabilitation Center, LLC

  • Chiropractor
  • Woodbury, MN
  • NPI 1053562058
  NPD tax ID

Locations

Practitioners 2

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.

• Jesse Jerod Crane, D.C.

  • Chiropractor
  • Woodbury, MN
  • NPI 1922133602
  Medicare reassignment Care Compare group Authorized official
• David James Wilson, DC

  • Chiropractor
  • Woodbury, MN
  • NPI 1053456699
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093864050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 VALLEY CREEK RD #145",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "651-734-1123",
            "fax_number": "651-734-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 VALLEY CREEK RD #145",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "651-734-1123",
            "fax_number": "651-734-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRANE",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "JEROD",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "651-734-1123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3831",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4269",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "97D66CH",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Chen, MD
• Abigail Cheng
• Marilyn Alysse Chengo, APRN
• Scott P Chepulis, OD
• Moriah Abigail Renee Chew
• Chiropractic Rehabilitation Center, LLC
• Chiroway of Woodbury, PLLC
• Maria Teresa Chmielewski, CNS
• Emily Moe Christensen, PT
• Halaina Irene Christensen, LICSW

• Chiropractor in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.