Individual provider Active NPI

Jeremy Nicholas Faue, D.C.

  • Chiropractor
  • Edina, MN
National Provider Identifier
1225320757
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5520 Issued in MN
Practice address
3400 W 66TH St Ste 128
Edina, MN 55435-2109
Phone
(952) 835-6750
NPI assigned
May 3, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 5520 MN Primary

Addresses

Primary practice location

3400 W 66TH St Ste 128
Edina, MN 55435-2109

Mailing address

4770 Quinwood LN N
Plymouth, MN 55442-2091
Phone (763) 670-1742

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
5520MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Exodus Chiropractic, PA Chiropractor Past Accepting new patients
Frach Chiropractic LLC Chiropractor Past Accepting new patients
Chiropractic Health & Wellness Center, P.a. Chiropractor PastSince Jan 1, 2002 Accepting new patients

Organizations & group practices 3

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": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1225320757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 QUINWOOD LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422091",
            "telephone_number": "763-670-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 128",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352109",
            "telephone_number": "952-835-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUE",
        "first_name": "JEREMY",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-03",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

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