Individual provider Active NPI

Daniel James Richter, D.C.

  • Chiropractor
  • Blaine, MN
National Provider Identifier
1154546901
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4619 Issued in MN
Practice address
13060 Central Ave NE
Suite 100
Blaine, MN 55434-4149
Phone
(763) 566-8023
Fax
(763) 566-0630
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4619 MN Primary

Addresses

Primary practice location

13060 Central Ave NE
Suite 100
Blaine, MN 55434-4149

Mailing address

13060 Central Ave NE
Suite # 100
Blaine, MN 55434-4149
Phone (763) 566-8023

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090129000600 MN Practitioner - Chiropractic 3072541788 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4619MNMDChiropractor
3606WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Doc DJR PC Chiropractor CurrentSince Aug 14, 2015 Accepting new patients
Michael J. Olson Chiropractor Past Accepting new patients
Olson CC Wellness LLC Chiropractor PastSince Jan 1, 2018 Accepting new patients

Locations

13060 Central Ave NE
Ste 100
Blaine, MN 55434
Phone (763) 566-8023

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1154546901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13060 CENTRAL AVE NE",
            "address_2": "SUITE # 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344149",
            "telephone_number": "763-566-8023",
            "fax_number": "763-566-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13060 CENTRAL AVE NE",
            "address_2": "SUITE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344149",
            "telephone_number": "763-566-8023",
            "fax_number": "763-566-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.