NPIMap

Organization Active NPI

Good Life Chiropractic LLC

  • Chiropractor
  • Sartell, MN
National Provider Identifier
1306420245
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GOOD LIFE CHIROPRACTIC LLC
Practice address
1733 Pine Cone Rd S Ste 1200
Sartell, MN 56377-5814
Phone
(320) 217-2542
NPI assigned
May 6, 2021
Last updated
May 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Elijah Johnson, DCNPI 1235713165
Title
Owner
Phone
(320) 438-4189

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

1733 Pine Cone Rd S Ste 1200
Sartell, MN 56377-5814

Mailing address

400 3Rd St S Apt 201
Sartell, MN 56377-2491

National Provider Directory

National Provider Directory

Locations

1733 Pine Cone Rd S
Ste 1200
Sartell, MN 56377
Phone (320) 217-2542

Practitioners & affiliated clinicians

Practitioners 1

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": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1306420245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 3RD ST S APT 201",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 PINE CONE RD S STE 1200",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563775814",
            "telephone_number": "320-217-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ELIJAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-438-4189",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.