Individual provider Active NPI

Carrie Ellen Clark, D.C.

  • Chiropractor
  • Edina, MN
National Provider Identifier
1164461703
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3928 Issued in MN
Practice address
3948 W 50TH St
Ste 203
Edina, MN 55424-1210
Phone
(952) 920-4528
Fax
(952) 927-4226
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3928 MN Primary

Addresses

Primary practice location

3948 W 50TH St
Ste 203
Edina, MN 55424-1210

Mailing address

9744 Woodridge Dr
Eden Prairie, MN 55347-4249
Phone (612) 382-7408

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060811000191 MN Practitioner - Chiropractic 6406859487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Traditionally HealthyGroup PAC ID 2567689169, 2 clinicians
50TH and France Chiropractic and Wellness PLLCGroup PAC ID 9335142314, 3 clinicians

Practice addresses (Care Compare)

1121 Jackson St NE
Suite 119
Minneapolis, MN 55413-1597
Phone (612) 382-7408

3948 W 50TH St
Suite 203
Edina, MN 55424-1253
Phone (952) 920-4528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Traditionally Healthy Chiropractor CurrentSince Mar 21, 2014 Accepting new patients
50TH & France Chiropractic & Wellness PLLC Chiropractor CurrentSince Apr 30, 2003 Accepting new patients
Jo & Clark Chiropractic, P.a. Chiropractor Past Accepting new patients

Locations

1121 Jackson St NE
Ste 119
Minneapolis, MN 55413
Phone (612) 382-7408

3948 W 50th St
Ste 203
Minneapolis, MN 55424
Phone (952) 920-4528

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164461703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9744 WOODRIDGE DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553474249",
            "telephone_number": "612-382-7408",
            "fax_number": "952-927-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3948 W 50TH ST",
            "address_2": "STE 203",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241210",
            "telephone_number": "952-920-4528",
            "fax_number": "952-927-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CARRIE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.