Organization Active NPI

Westside Chiropractic Clinic, Inc.

  • Chiropractor
  • Saint Cloud, MN
National Provider Identifier
1285767525
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
002715 Issued in MN
Legal business name
WESTSIDE CHIROPRACTIC CLINIC, INC.
Practice address
4142 2ND St S
Saint Cloud, MN 56301-3704
Phone
(320) 255-5188
Fax
(320) 255-1969
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Brian Lee Hilbert, D.C.NPI 1841388113
Title
Owner
Phone
(320) 255-5188

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X 002715 MN Primary

Addresses

Primary practice location

4142 2ND St S
Saint Cloud, MN 56301-3704

Mailing address

4142 2ND St S
Saint Cloud, MN 56301-3704
Phone (320) 255-5188

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050825000803 MN Part B Supplier - Clinic/Group Practice 6608807045 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Cloud, MN

National Provider Directory

National Provider Directory

Locations

4142 2nd St S
Saint Cloud, MN 56301
Phone (320) 230-8080

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285767525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4142 2ND ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013704",
            "telephone_number": "320-255-5188",
            "fax_number": "320-255-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4142 2ND ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013704",
            "telephone_number": "320-255-5188",
            "fax_number": "320-255-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HILBERT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-255-5188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "002715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.