Renata R Evertz, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

383670534 Issued in MN

Practice address

9325 Upland Lane N Suit 230
Maple Grove, MN 55369

Phone

(763) 315-0466

NPI assigned

Dec 27, 2010

Last updated

Jan 27, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Perham Physical Therapy LTD.

  dba Orthology

  • Physical Therapist
  • Eden Prairie, MN
  • NPI 1437451853
  NPD

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1184928665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 94TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55434",
            "telephone_number": "763-232-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LANE N SUIT 230",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-315-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERTZ",
        "first_name": "RENATA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "383670534",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": "383670534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sadiya Abdirahman Esse
• Jade Robin Estola
• Bachu Mekonnen Eticha
• Everest Psychological Services
• Terry L Evers, APNP
• Hannah Mathilde Evju
• Amanda Exman, PSY.D., LP
• Gina Fabiano, LAC
• Fairview Clinics (Fairview Clinics-Bass Lake)
• Fairview Clinics (Fairview Clinics-Maple Grove)

• Chiropractor in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.