Organization Active NPI

For Your Well Being Chiropractic, S.C.

  • Chiropractor
  • White Bear Lake, MN
National Provider Identifier
1154743300
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FOR YOUR WELL BEING CHIROPRACTIC, S.C.
Practice address
2479 County Road E E
White Bear Lake, MN 55110-4807
Phone
(651) 770-5433
NPI assigned
Jan 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Dr. Travis Beauchamp, D.C.
Title
President
Phone
(651) 770-5433

Specialties & licenses 1

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

Addresses

Primary practice location

2479 County Road E E
White Bear Lake, MN 55110-4807

Mailing address

2479 County Road E E
White Bear Lake, MN 55110-4807
Phone (651) 770-5433

National Provider Directory

National Provider Directory

Locations

2479 County Road E E
White Bear Lk, MN 55110
Phone (651) 770-5433

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1154743300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2479 COUNTY ROAD E E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104807",
            "telephone_number": "651-770-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2479 COUNTY ROAD E E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104807",
            "telephone_number": "651-770-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOR YOUR WELL BEING CHIROPRACTIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "BEAUCHAMP",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-770-5433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.