Organization Active NPI

Zika Chiropractic, PLLC

  • Clinic/Center
  • Lakeville, MN
National Provider Identifier
1174047617
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
5402 Issued in MN
Legal business name
ZIKA CHIROPRACTIC, PLLC
Practice address
17652 Kenwood TRL
Lakeville, MN 55044-9764
Phone
(952) 406-0062
NPI assigned
Jul 26, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Jacob William Zika, DCNPI 1881870897
Title
Chief Manager
Phone
(952) 595-6325

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
Clinic/Center 261Q00000X 5402 MN Primary

Addresses

Primary practice location

17652 Kenwood TRL
Lakeville, MN 55044-9764

Mailing address

17652 Kenwood TRL
Lakeville, MN 55044-9764
Phone (952) 595-6325

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170901001255 MN Part B Supplier - Clinic/Group Practice 8628341211 Receives reassigned benefits from 1 practitioner
Practice locations: Lakeville, MN

National Provider Directory

National Provider Directory

Locations

17652 Kenwood Trl
Lakeville, MN 55044
Phone (952) 406-0062

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1174047617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17652 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449764",
            "telephone_number": "952-595-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17652 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449764",
            "telephone_number": "952-406-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZIKA CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ZIKA",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "952-595-6325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "5402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.