Organization Active NPI

Healing Choices LLC

  • Clinic/Center
  • Elk River, MN
National Provider Identifier
1275705758
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
3500 Issued in MN
Legal business name
HEALING CHOICES LLC
Practice address
200 5TH St NW
Elk River, MN 55330-1917
Phone
(763) 241-5436
NPI assigned
Mar 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Authorized official

Name
Dr. John William Larson, DCNPI 1285642975
Title
Owner
Phone
(763) 241-5436

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
Clinic/Center 261Q00000X 3500 MN Primary

Addresses

Primary practice location

200 5TH St NW
Elk River, MN 55330-1917

Mailing address

18140 Zane St NW # 303
Elk River, MN 55330-4505
Phone (763) 241-5436

Other identifiers 4

IdentifierTypeStateIssuer
407660000MedicaidMN
C03743OtherMNMEDICARE LEGACY
DG5136OtherGARAILROAD MEDICARE
132M0HEOtherMNBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180430000776 MN Part B Supplier - Clinic/Group Practice 8123382181 Receives reassigned benefits from 3 practitioners
Practice locations: Elk River, MN

National Provider Directory

National Provider Directory

Locations

221 Main St NW
Ste E
Elk River, MN 55330
Phone (763) 241-5436

18140 Zane St NW
Elk River, MN 55330
Phone (612) 293-0427

19021 Freeport St NW
Ste 500
Elk River, MN 55330
Phone (763) 241-5436

231 Main St NW
Elk River, MN 55330
Phone (763) 241-5436

Practitioners & affiliated clinicians

Practitioners 3

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": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1275705758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18140 ZANE ST NW # 303",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304505",
            "telephone_number": "763-241-5436",
            "fax_number": "763-241-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 5TH ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301917",
            "telephone_number": "763-241-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING CHOICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-241-5436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "3500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407660000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY",
            "identifier": "C03743",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG5136",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "132M0HE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.