Organization Active NPI

Complete Chiropractic Inc

  • Chiropractor
  • Dundas, MN
National Provider Identifier
1225218282
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4075 Issued in MN
Legal business name
COMPLETE CHIROPRACTIC INC
Practice address
303 Hester St W
Dundas, MN 55019-3970
Phone
(507) 645-0333
NPI assigned
Nov 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Dr. Grant Louis Modory, D.C.NPI 1548300932
Title
Chiropractor
Phone
(507) 645-3176

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: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4075 MN Primary

Addresses

Primary practice location

303 Hester St W
Dundas, MN 55019-3970

Mailing address

303 Hester St W
Dundas, MN 55019-3970
Phone (507) 645-0333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050915000342 MN Part B Supplier - Clinic/Group Practice 1456384973 Receives reassigned benefits from 1 practitioner
Practice locations: Dundas, MN

National Provider Directory

National Provider Directory

Locations

303 Hester St W
Dundas, MN 55019
Phone (507) 645-0333

708 Schilling Dr N
#5
Dundas, MN 55019
Phone (507) 645-0333

Practitioners & affiliated clinicians

Practitioners 1

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": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1225218282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 HESTER ST W",
            "city": "DUNDAS",
            "state": "MN",
            "postal_code": "550193970",
            "telephone_number": "507-645-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 HESTER ST W",
            "city": "DUNDAS",
            "state": "MN",
            "postal_code": "550193970",
            "telephone_number": "507-645-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "MODORY",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "507-645-3176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dundas, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.