Individual provider Active NPI

Adam Hunter Millsop, D.C.

  • Chiropractor
  • Shoreview, MN
National Provider Identifier
1205009792
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5103 Issued in MN
Practice address
3570 Lexington Ave N
Ste 208
Shoreview, MN 55126-8049
Phone
(651) 400-7026
Fax
(651) 481-8051
NPI assigned
Apr 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5103 MN Primary

Addresses

Primary practice location

3570 Lexington Ave N
Ste 208
Shoreview, MN 55126-8049

Mailing address

3570 Lexington Ave N
Ste 208
Shoreview, MN 55126-8049
Phone (651) 400-7026

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080530000649 MN Practitioner - Chiropractic 8426128661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millsop Chiropractic, P.a.Group PAC ID 2062582208, 3 clinicians

Practice addresses (Care Compare)

3570 Lexington Ave N
Suite 208
Shoreview, MN 55126-8058
Phone (651) 400-7026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5103MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Millsop Chiropractic, P.a. Chiropractor CurrentSince Apr 15, 2008 Accepting new patients
Preferred Chiropractic Associates Inc CurrentSince Apr 15, 2008 Accepting new patients
Trillium Chiropractic, P.a. Chiropractor Past Accepting new patients
Cich Chiropractic Chiropractor Past Accepting new patients

Locations

4080 W Broadway Ave
Ste 310
Robbinsdale, MN 55422
Phone (763) 746-1244

3570 Lexington Ave N
Ste 208
Shoreview, MN 55126
Phone (651) 400-7026

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1205009792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 LEXINGTON AVE N",
            "address_2": "STE 208",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268049",
            "telephone_number": "651-400-7026",
            "fax_number": "651-481-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 LEXINGTON AVE N",
            "address_2": "STE 208",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268049",
            "telephone_number": "651-400-7026",
            "fax_number": "651-481-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLSOP",
        "first_name": "ADAM",
        "middle_name": "HUNTER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-07",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.