NPIMap

Organization Active NPI

Inver Grove Chiropractic P a

  • Chiropractor
  • Inver Grove Heights, MN
National Provider Identifier
1194904417
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1591 Issued in MN
Legal business name
INVER GROVE CHIROPRACTIC P A
Practice address
2940 65TH St E
Inver Grove Heights, MN 55076-2040
Phone
(651) 451-1012
Fax
(651) 453-1543
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Dr. Ross David Crain, D.CNPI 1376969782
Title
President
Phone
(651) 451-1012

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1591 MN Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

2940 65TH St E
Inver Grove Heights, MN 55076-2040

Mailing address

2940 65TH St E
Inver Grove Heights, MN 55076-2040
Phone (651) 451-1012

Other identifiers 4

IdentifierTypeStateIssuer
3707978MedicaidMN
59869INOtherMNBLUE CROSS BLUE SHIELD
94265OtherMNMEDICA
230730OtherMNCHIRO CARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100616000902 MN Part B Supplier - Clinic/Group Practice 6709916802 Receives reassigned benefits from 5 practitioners
Practice locations: Inver Grove Heights, MN

National Provider Directory

National Provider Directory

Locations

2940 65th St E
Inver Grove Heights, MN 55076
Phone (651) 451-1012

Practitioners & affiliated clinicians

Practitioners 9

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": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1194904417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 65TH ST E",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550762040",
            "telephone_number": "651-451-1012",
            "fax_number": "651-453-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 65TH ST E",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550762040",
            "telephone_number": "651-451-1012",
            "fax_number": "651-453-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INVER GROVE CHIROPRACTIC P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "CRAIN",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-451-1012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1591",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3707978",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "59869IN",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "94265",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIRO CARE",
            "identifier": "230730",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inver Grove Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.