Individual provider Active NPI

Wayne Edward Pratt, D.C.

  • Chiropractor
  • Andover, MN
National Provider Identifier
1255337408
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2677 Issued in MN
Practice address
13750 Crosstown Dr NW
Suite L102
Andover, MN 55304-5853
Phone
(763) 767-1800
Fax
(763) 767-1818
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2677 MN Primary

Addresses

Primary practice location

13750 Crosstown Dr NW
Suite L102
Andover, MN 55304-5853

Mailing address

13750 Crosstown Dr NW
Suite L102
Andover, MN 55304-5853
Phone (763) 767-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040420000513 MN Practitioner - Chiropractic 0042205841 Practice locations: Andover, MN

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13750 Crosstown Dr NW
Suite 204
Andover, MN 55304-5856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heil Chiropractic Center PA Chiropractor Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1255337408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13750 CROSSTOWN DR NW",
            "address_2": "SUITE L102",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553045853",
            "telephone_number": "763-767-1800",
            "fax_number": "763-767-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13750 CROSSTOWN DR NW",
            "address_2": "SUITE L102",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553045853",
            "telephone_number": "763-767-1800",
            "fax_number": "763-767-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "WAYNE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.