Revelation Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5186 Issued in MN

Legal business name

REVELATION CHIROPRACTIC PLLC

Practice address

8112 Upton Ave S
Bloomington, MN 55431-1248

Phone

(612) 267-9281

NPI assigned

Sep 9, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Richard Baker, D.C.

Title

Owner/Ceo

Phone

(612) 267-9281

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1144502733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8112 UPTON AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8112 UPTON AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311248",
            "telephone_number": "612-267-9281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVELATION CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "612-267-9281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Bloomington, MN
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• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.