Individual provider Active NPI

Kevin C. Juleen, D.C.

  • Chiropractor
  • Shoreview, MN
National Provider Identifier
1205258464
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5871 Issued in MN
Practice address
1000 County Road E W Ste 210
Shoreview, MN 55126-8096
Phone
(651) 766-4600
Fax
(651) 766-4603
NPI assigned
Jan 7, 2014
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5871 MN Primary

Addresses

Primary practice location

1000 County Road E W Ste 210
Shoreview, MN 55126-8096

Mailing address

1000 County Road E W Ste 210
Shoreview, MN 55126-8096
Phone (651) 766-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5871MNMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1205258464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 COUNTY ROAD E W STE 210",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268096",
            "telephone_number": "651-766-4600",
            "fax_number": "651-766-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 COUNTY ROAD E W STE 210",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268096",
            "telephone_number": "651-766-4600",
            "fax_number": "651-766-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JULEEN",
        "first_name": "KEVIN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-07",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5871",
            "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 Jan 16, 2024; 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.