NPIMap

Organization Active NPI

Archetype Chiropractic Center

  • Chiropractor
  • Waite Park, MN
National Provider Identifier
1144498593
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4430 Issued in MN
Legal business name
ARCHETYPE CHIROPRACTIC CENTER
Practice address
71 10TH Ave S
Waite Park, MN 56387-1040
Phone
(320) 259-9099
NPI assigned
Feb 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Authorized official

Name
Dr. Shawn P Preisler
Title
Owner
Phone
(320) 259-9099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4430 MN Primary

Addresses

Primary practice location

71 10TH Ave S
Waite Park, MN 56387-1040

Mailing address

71 10TH Ave So
Waite Park, MN 56387-1040

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1144498593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 10TH AVE SO",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 10TH AVE S",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871040",
            "telephone_number": "320-259-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHETYPE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "PREISLER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-259-9099",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waite Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.