Individual provider Active NPI

Cody Neil King, DC

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1275343873
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7302 Issued in MN
Practice address
34 13TH Ave NE Ste 109
Minneapolis, MN 55413-1007
Phone
(612) 378-1050
Fax
(612) 378-1051
NPI assigned
Jan 7, 2025
Last updated
Jul 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7302 MN Primary

Addresses

Primary practice location

34 13TH Ave NE Ste 109
Minneapolis, MN 55413-1007

Mailing address

34 13TH Ave NE Ste 109
Minneapolis, MN 55413-1007
Phone (612) 378-1050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251008002427 MN Practitioner - Chiropractic 3779005327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Clinic, P.a.Group PAC ID 5799934857, 19 clinicians

Practice addresses (Care Compare)

6233 Baker Rd
Eden Prairie, MN 55346-1922
Phone (952) 943-4659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7302MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Clinic, P.a. CurrentSince Dec 15, 2025 Accepting new patients
Northeast Chiropractic PLLC Chiropractor CurrentSince Aug 24, 2025 Accepting new patients

Locations

6233 Baker Rd
Eden Prairie, MN 55346
Phone (952) 943-4659

34 13th Ave NE
Ste 109
Minneapolis, MN 55413
Phone (612) 378-1050

33 Hamline Ave S
Saint Paul, MN 55105
Phone (612) 868-6894

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": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1275343873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 13TH AVE NE STE 109",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131007",
            "telephone_number": "612-378-1050",
            "fax_number": "612-378-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 13TH AVE NE STE 109",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131007",
            "telephone_number": "612-378-1050",
            "fax_number": "612-378-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "CODY",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "7302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; 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.