Y-Chiropractic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

Y-CHIROPRACTIC

Practice address

10700 Highway 55
Suite 100
Plymouth, MN 55441-6100

Phone

(763) 543-9080

Fax

(763) 543-9082

NPI assigned

Feb 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Paul Daeboo Moon, D.C.NPI 1871663815

Title

Chiropractor/Owner

Phone

(763) 543-9080

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

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

• Paul Daeboo Moon, D.C.

  • Chiropractor
  • Plymouth, MN
  • NPI 1871663815
  Medicare reassignment Authorized official
• Brian Dale Boyd, DC

  • Chiropractor
  • Plymouth, MN
  • NPI 1376608570
  NPD

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1275711764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 HIGHWAY 55",
            "address_2": "SUITE 100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416100",
            "telephone_number": "763-543-9080",
            "fax_number": "763-543-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 HIGHWAY 55",
            "address_2": "SUITE 100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416100",
            "telephone_number": "763-543-9080",
            "fax_number": "763-543-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "Y-CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DAEBOO",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "763-543-9080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Wyatt, DC
• Dao Xiong, SCHOOL PSYCHOLOGIST
• Der Xiong, DNP
• Gaoyee Xiong
• Lee Xiong
• Cassidy Yang
• Mia Amao Yang, CNP
• Sabrena Yeazle, BCBA
• Audrey Anne Yee
• Jessica Yee

• Clinic/Center in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.