Experience Wellness Chiropractic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EXPERIENCE WELLNESS CHIROPRACTIC PA

Practice address

3001 Harbor LN N
Plymouth, MN 55447-5102

Phone

(763) 383-5109

Fax

(763) 383-2937

NPI assigned

Jul 9, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Nicholas Faue, DC

Title

Ceo

Phone

(763) 670-1742

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Brenna Dilley

  • Pediatric Chiropractor
  • Brooten, MN
  • NPI 1356179956
  NPD

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1275370215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 HARBOR LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475102",
            "telephone_number": "763-383-5109",
            "fax_number": "763-383-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HARBOR LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475102",
            "telephone_number": "763-383-5109",
            "fax_number": "763-383-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIENCE WELLNESS CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "FAUE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-670-1742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wanda J Ethen, MD
• Jocelyn Marijke Etten, CRNA
• Evan Hall Joseph Evan Hall, LADC
• Evercare Hospice, Inc.
• Jennifer Exo, DO
• Nicole A Fairburn
• Fairview Pharmacy Services, LLC
• Family & Cosmetic Gentle Dentistry, LTD
• Family Wellness Chiropractic, PC
• Khalil Wadih Simon Farah, M.D.

• Chiropractor in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.