NPIMap

Organization Active NPI

Lund Health Professional Corporation

Doing business as Blaine Health and Wellness

  • Chiropractor
  • Blaine, MN
National Provider Identifier
1194197368
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5464 Issued in MN
Legal business name
LUND HEALTH PROFESSIONAL CORPORATION
Doing business as
Blaine Health and Wellness
Practice address
1360 101St Ave NE
Suite 140
Blaine, MN 55449
Phone
(763) 703-3509
Fax
(763) 703-3454
NPI assigned
Oct 27, 2015
Last updated
Oct 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Authorized official

Name
Dr. Brian James Lund, DCNPI 1457656613
Title
President
Phone
(763) 703-3509

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 5464 MN Primary

Addresses

Primary practice location

1360 101St Ave NE
Suite 140
Blaine, MN 55449

Mailing address

1630 101St Ave NE Ste 140
Blaine, MN 55449-4419
Phone (763) 703-3509

Other names 1

  • Blaine Health and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160114000596 MN Part B Supplier - Clinic/Group Practice 3779886361 Receives reassigned benefits from 6 practitioners
Practice locations: Blaine, MN

National Provider Directory

National Provider Directory

Locations

1630 101st Ave NE
Ste 140
Minneapolis, MN 55449
Phone (763) 703-3509

Practitioners & affiliated clinicians

Practitioners 8

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": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1194197368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 101ST AVE NE STE 140",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494419",
            "telephone_number": "763-703-3509",
            "fax_number": "763-703-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 101ST AVE NE",
            "address_2": "SUITE 140",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55449",
            "telephone_number": "763-703-3509",
            "fax_number": "763-703-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUND HEALTH PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "LUND",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-703-3509",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blaine Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.