Organization Active NPI

Domier Chiropractic, PLLC

  • Chiropractor
  • Prior Lake, MN
National Provider Identifier
1114615150
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DOMIER CHIROPRACTIC, PLLC
Practice address
16180 Hastings Ave SE Ste 202
Prior Lake, MN 55372-9228
Phone
(952) 991-1353
NPI assigned
Apr 27, 2023
Last updated
Apr 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Brittany Ann Domier, DCNPI 1609112622
Title
Chiropractic
Phone
(612) 207-8727

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 NU Primary

Addresses

Primary practice location

16180 Hastings Ave SE Ste 202
Prior Lake, MN 55372-9228

Mailing address

16180 Hastings Ave SE Ste 202
Prior Lake, MN 55372-9228
Phone (952) 991-1353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230724000953 MN Part B Supplier - Clinic/Group Practice 1658731559 Receives reassigned benefits from 1 practitioner
Practice locations: Prior Lake, MN

National Provider Directory

National Provider Directory

Locations

16180 Hastings Ave SE
Ste 202
Prior Lake, MN 55372
Phone (952) 991-1353

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1114615150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16180 HASTINGS AVE SE STE 202",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553729228",
            "telephone_number": "952-991-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16180 HASTINGS AVE SE STE 202",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553729228",
            "telephone_number": "952-991-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMIER CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "DOMIER",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIROPRACTIC",
        "authorized_official_telephone_number": "612-207-8727",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prior Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.