Crossroads Chiropractic Clinic

Key facts

NPI

1215080940

Entity type

Organization (NPI type 2)

Primary specialty

Chiropractor 111N00000X

License

2457 (MN)

Legal business name

CROSSROADS CHIROPRACTIC CLINIC

Practice address

4544 County Road 134
Suite B
Saint Cloud, MN 56303-4813

Phone

(320) 252-3711

NPI assigned

Jan 18, 2007

Organization subpart

No

Authorized official

Name

Karen Ann Holien

Title

Office Manager

Phone

(320) 252-1167

Practitioners 6

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

• Tammy K Dickinson, D.C. Chiropractor · Sartell, MN · NPI 1548209265
  Medicare reassignment Care Compare group NPD CHIROPRACTOR · MN
• Eric Michael Oltmanns, D.C. Chiropractor · Saint Cloud, MN · NPI 1356683114
  Medicare reassignment Care Compare group NPD CHIROPRACTOR · MN
• Jeffrey John Varner, DC Chiropractor · St Cloud, MN · NPI 1639266109
  Medicare reassignment Care Compare group NPD CHIROPRACTOR · MN
• Chad F Spaulding, D.C. Chiropractor · Sartell, MN · NPI 1821083957
  NPD (past) CHIROPRACTOR
• Eric Stroh, D.C. Chiropractor · Anoka, MN · NPI 1245572841
  NPD (past) CHIROPRACTOR
• Jaclyn Merry Bergstrom, D.C Chiropractor · Portland, OR · NPI 1598715336
  NPD (past) CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MN

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215080940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4544 COUNTY ROAD 134",
            "address_2": "SUITE B",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034813",
            "telephone_number": "320-252-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4544 COUNTY ROAD 134",
            "address_2": "SUITE B",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034813",
            "telephone_number": "320-252-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLIEN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "320-252-1167"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2457",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2974",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Saint Cloud, MN · Chiropractor in Minnesota