NPIMap

Organization Active NPI

Back to Life Chiropractic PC

  • Chiropractor
  • Stillwater, MN
National Provider Identifier
1245440502
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC3791 Issued in MN
Legal business name
BACK TO LIFE CHIROPRACTIC PC
Practice address
333 Main St N Ste 203
Stillwater, MN 55082-5054
Phone
(651) 430-0018
Fax
(651) 430-0019
NPI assigned
May 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nancy Ann Swenson, DCNPI 1114079431
Title
Chiropractor
Phone
(651) 430-0018

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC3791 MN Primary

Addresses

Primary practice location

333 Main St N Ste 203
Stillwater, MN 55082-5054

Mailing address

333 Main St N Ste 203
Stillwater, MN 55082-5054
Phone (651) 430-0018

National Provider Directory

National Provider Directory

Locations

333 Main St N
Ste 203
Stillwater, MN 55082
Phone (651) 271-4163

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245440502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 MAIN ST N STE 203",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825054",
            "telephone_number": "651-430-0018",
            "fax_number": "651-430-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 MAIN ST N STE 203",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825054",
            "telephone_number": "651-430-0018",
            "fax_number": "651-430-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO LIFE CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SWENSON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "651-430-0018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "DC3791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.