NPIMap

Organization Active NPI

Illuminnate Family Chiropractic, Inc.

  • Chiropractor
  • Lake Elmo, MN
National Provider Identifier
1174730048
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4731 Issued in MN
Legal business name
ILLUMINNATE FAMILY CHIROPRACTIC, INC.
Practice address
8931 Highway 5
Suite a
Lake Elmo, MN 55042-8900
Phone
(651) 204-0926
Fax
(651) 204-3031
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Authorized official

Name
Dr. John Christian Ward, D.C.
Title
President
Phone
(952) 239-0050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4731 MN Primary

Addresses

Primary practice location

8931 Highway 5
Suite a
Lake Elmo, MN 55042-8900

Mailing address

8931 Highway 5
Suite a
Lake Elmo, MN 55042-8900
Phone (651) 204-0926

National Provider Directory

National Provider Directory

Locations

8931 Highway 5
Ste A
Lake Elmo, MN 55042
Phone (651) 204-0926

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1174730048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8931 HIGHWAY 5",
            "address_2": "SUITE A",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428900",
            "telephone_number": "651-204-0926",
            "fax_number": "651-204-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 HIGHWAY 5",
            "address_2": "SUITE A",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428900",
            "telephone_number": "651-204-0926",
            "fax_number": "651-204-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINNATE FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHRISTIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-239-0050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elmo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.