NPIMap

Organization Active NPI

Premier Health of South Minneapolis LTD

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1194912444
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PREMIER HEALTH OF SOUTH MINNEAPOLIS LTD
Practice address
1813 E Lake St
Minneapolis, MN 55407-1835
Phone
(612) 746-5557
Fax
(612) 746-5559
NPI assigned
Oct 1, 2007
Last updated
Sep 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Authorized official

Name
Larry L Estebo, DCNPI 1285766352
Title
President Owner
Phone
(651) 379-1842

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1813 E Lake St
Minneapolis, MN 55407-1835

Mailing address

1813 E Lake St
Minneapolis, MN 55407-1835
Phone (612) 746-5557

National Provider Directory

National Provider Directory

Locations

1813 E Lake St
Minneapolis, MN 55407
Phone (612) 746-5557

Practitioners & affiliated clinicians

Practitioners 7

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": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1194912444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 E LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071835",
            "telephone_number": "612-746-5557",
            "fax_number": "612-746-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 E LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071835",
            "telephone_number": "612-746-5557",
            "fax_number": "612-746-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH OF SOUTH MINNEAPOLIS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "ESTEBO",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "651-379-1842",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.