Individual provider Active NPI

Jean Ciola, DC

  • Chiropractor
  • Minnetonka, MN
National Provider Identifier
1235219767
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4542 Issued in MN
Practice address
3311 County Road 101
Suite 2
Minnetonka, MN 55391
Phone
(952) 405-6263
Fax
(952) 406-8060
NPI assigned
Oct 17, 2006
Last updated
Jul 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4542 MN Primary

Addresses

Primary practice location

3311 County Road 101
Suite 2
Minnetonka, MN 55391

Mailing address

3311 County Rd 101 Suite 2
Minnetonka, MN 55391-2866
Phone (952) 405-6263

Other identifiers 2

IdentifierTypeStateIssuer
345422300MedicaidMN
919S6CIOtherMNBCBS PROVIDER ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000364 MN Practitioner - Chiropractic 0446214084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3311 County Rd 101
Suite 3
Wayzata, MN 55391-2879
Phone (952) 405-6263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4542MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Aagesen Chiropractic Clinic PA Chiropractor PastSince Mar 25, 2013 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1235219767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 COUNTY RD 101 SUITE 2",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553912866",
            "telephone_number": "952-405-6263",
            "fax_number": "952-406-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 COUNTY ROAD 101",
            "address_2": "SUITE 2",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55391",
            "telephone_number": "952-405-6263",
            "fax_number": "952-406-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIOLA",
        "first_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345422300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "919S6CI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.