Organization Active NPI

Linden Chiropractic Clinic P.a.

  • Rehabilitation Chiropractor
  • Willmar, MN
National Provider Identifier
1154513489
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
Legal business name
LINDEN CHIROPRACTIC CLINIC P.A.
Practice address
1604 1St St S
Willmar, MN 56201-4243
Phone
(320) 231-2513
Fax
(320) 231-3135
NPI assigned
Aug 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Authorized official

Name
Thomas Charles Linden, D.C.NPI 1649356213
Title
Owner/Operator
Phone
(320) 231-2513

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
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X Primary

Addresses

Primary practice location

1604 1St St S
Willmar, MN 56201-4243

Mailing address

1604 1St St S
Willmar, MN 56201-4243
Phone (320) 231-2513

Other identifiers 2

IdentifierTypeStateIssuer
762528600MedicaidMN
60676LIOtherMNBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050715000319 MN Part B Supplier - Clinic/Group Practice 5395771851 Receives reassigned benefits from 1 practitioner
Practice locations: Willmar, MN

National Provider Directory

National Provider Directory

Locations

102 Minnesota Ave SW
Willmar, MN 56201
Phone (320) 231-2513

Practitioners & affiliated clinicians

Practitioners 1

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": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1154513489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 1ST ST S",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014243",
            "telephone_number": "320-231-2513",
            "fax_number": "320-231-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 1ST ST S",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014243",
            "telephone_number": "320-231-2513",
            "fax_number": "320-231-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDEN CHIROPRACTIC CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "LINDEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "320-231-2513",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "762528600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "60676LI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.