Organization Active NPI

Balanced Chiropractic LLC

  • Chiropractor
  • Robbinsdale, MN
National Provider Identifier
1184288698
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BALANCED CHIROPRACTIC LLC
Practice address
3946 Zane Ave N
Robbinsdale, MN 55422-1961
Phone
(612) 708-8500
NPI assigned
Apr 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Authorized official

Name
Jonathan Morris, DCNPI 1609140318
Title
Chiropractor
Phone
(612) 708-8500

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3946 Zane Ave N
Robbinsdale, MN 55422-1961

Mailing address

3946 Zane Ave N
Robbinsdale, MN 55422-1961
Phone (612) 708-8500

Other names 1

  • Balanced Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200224000261 MN Part B Supplier - Clinic/Group Practice 9436586948 Receives reassigned benefits from 1 practitioner
Practice locations: Plymouth, MN

National Provider Directory

National Provider Directory

Locations

12805 Highway 55
Ste 311
Plymouth, MN 55441
Phone (763) 205-2191

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1184288698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3946 ZANE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221961",
            "telephone_number": "612-708-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3946 ZANE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221961",
            "telephone_number": "612-708-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "612-708-8500",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Balanced Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Robbinsdale, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.