Organization Active NPI

Mounds View Chiropractic, PA

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1306053673
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4950 Issued in MN
Legal business name
MOUNDS VIEW CHIROPRACTIC, PA
Practice address
5372 Edgewood Dr
Saint Paul, MN 55112-1402
Phone
(763) 398-7770
Fax
(763) 398-7771
NPI assigned
May 17, 2007
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Dr. Joshua Ryan Huffman, D.C.NPI 1235341561
Title
President
Phone
(763) 398-7770

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
Chiropractor 111N00000X 4950 MN Primary

Addresses

Primary practice location

5372 Edgewood Dr
Saint Paul, MN 55112-1402

Mailing address

5372 Edgewood Dr
Saint Paul, MN 55112-1402
Phone (763) 398-7770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070530000520 MN Part B Supplier - Clinic/Group Practice 7911005814 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

5372 Edgewood Dr
Saint Paul, MN 55112
Phone (763) 398-7770

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1306053673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5372 EDGEWOOD DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551121402",
            "telephone_number": "763-398-7770",
            "fax_number": "763-398-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5372 EDGEWOOD DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551121402",
            "telephone_number": "763-398-7770",
            "fax_number": "763-398-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNDS VIEW CHIROPRACTIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "HUFFMAN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-398-7770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.