Cannon Valley Chiropractic,LLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

4074 Issued in MN

Legal business name

CANNON VALLEY CHIROPRACTIC,LLC

Practice address

6505 Cedar Hills Dr
Cannon Falls, MN 55009-4253

Phone

(507) 263-3925

Fax

(507) 263-5065

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Matthew August Maki, D.C.NPI 1215011044

Title

Owner/Doctor

Phone

(507) 263-3925

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 2

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

• Matthew August Maki, D.C.

  • Sports Physician Chiropractor
  • Cannon Falls, MN
  • NPI 1215011044

  MN

  Medicare reassignment Authorized official
• Julie Elizabeth Hughes, DC

  • Chiropractor
  • Lakeville, MN
  • NPI 1356497242
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194809863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 CEDAR HILLS DR",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550094253",
            "telephone_number": "507-263-3925",
            "fax_number": "507-263-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 CEDAR HILLS DR",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550094253",
            "telephone_number": "507-263-3925",
            "fax_number": "507-263-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON VALLEY CHIROPRACTIC,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAKI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "AUGUST",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "507-263-3925",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": "4074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "01N79CA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cannon Falls Family Dental
• Cannon Falls Isd #252
• Cannon Falls Medical Center
• Cannon Falls Nursing Rehabilitation, LLC
• Cannon Falls Snyder Phcy Inc
• Chasing Life-With Kala Marie
• Evie Christensen
• City of Cannon Falls
• Compass Dental PA
• Fiona Ethel Demel, D.C.

• Sports Physician Chiropractor in Cannon Falls, MN
• Providers in Cannon Falls, MN by specialty
• Sports Physician Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.