Individual provider Active NPI

Taylor Koloc, DC, MS

  • Chiropractor
  • Eden Prairie, MN
National Provider Identifier
1235868514
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6996 Issued in MN
Practice address
8577 Columbine Rd
Eden Prairie, MN 55344-9001
Phone
(942) 479-0043
NPI assigned
Jun 10, 2022
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6996 MN Primary

Addresses

Primary practice location

8577 Columbine Rd
Eden Prairie, MN 55344-9001

Mailing address

8577 Columbine Rd
Eden Prairie, MN 55344-9001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250415001283 MN Practitioner - Chiropractic 5597280347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knewtson Family Chiropractic PAGroup PAC ID 3779532593, 8 clinicians

Practice addresses (Care Compare)

23505 Smithtown Rd
Excelsior, MN 55331-4541
Phone (952) 470-8555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6996MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Knewtson Family Chiropractic PA Chiropractor CurrentSince Mar 31, 2025 Accepting new patients

Locations

23505 Smithtown Rd
Shorewood, MN 55331
Phone (952) 470-8555

23505 Smithtown Rd
Ste 100
Shorewood, MN 55331
Phone (952) 426-0874

Organizations & group practices 1

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1235868514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8577 COLUMBINE RD",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553449001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8577 COLUMBINE RD",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553449001",
            "telephone_number": "942-479-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLOC",
        "first_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "DC, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.