Organization Active NPI

Woodlake Chiropractic, Inc.

  • Chiropractor
  • Richfield, MN
National Provider Identifier
1265447023
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2352 Issued in MN
Legal business name
WOODLAKE CHIROPRACTIC, INC.
Practice address
6701 Lyndale Ave S
Richfield, MN 55423-2315
Phone
(612) 866-9194
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Paul J Zilka, D.C.NPI 1003821851
Title
Chiropractor
Phone
(612) 866-9194

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2352 MN Primary

Addresses

Primary practice location

6701 Lyndale Ave S
Richfield, MN 55423-2315

Mailing address

6701 Lyndale Ave S
Richfield, MN 55423-2315

Other identifiers 2

IdentifierTypeStateIssuer
25943HUOtherMNBLUE CROSS BLUE SHIELD
01400ZIOtherMNBLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060831000326 MN Part B Supplier - Clinic/Group Practice 7517961774 Receives reassigned benefits from 1 practitioner
Practice locations: Richfield, MN

National Provider Directory

National Provider Directory

Locations

6701 Lyndale Ave S
Richfield, MN 55423
Phone (612) 866-9194

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1265447023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 LYNDALE AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 LYNDALE AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232315",
            "telephone_number": "612-866-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAKE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "ZILKA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "612-866-9194",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "25943HU",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "01400ZI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.